Heterotopic ossification causing radiculopathy after lumbar total disc arthroplasty

Keith L. Jackson, Justin M. Hire, Jeremy M. Jacobs, Charles C. Key, John Glenden DeVine

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

To date, no reports have presented radiculopathy secondary to heterotopic ossification following lumbar total disc arthroplasty. The authors present a previously unpublished complication of lumbar total disk arthroplasty (TDA) secondary to heterotopic ossification (HO) in the spinal canal, and they propose a modification to the McAfee classification of HO. The patient had undergone an L5/S1 lumbar TDA two years prior due to discogenic back pain. His preoperative back pain was significantly relieved, but he developed new, atraumatic onset radiculopathy. Radiographs and a computed tomography myelogram revealed an implant malposition posteriorly with heterotopic bone formation in the canal, causing an impingement of the traversing nerve root. Revision surgery was performed with implant extraction, L5/S1 anterior lumbar interbody fusion, supplemental posterior decompression, and pedicle screw fixation. The patient tolerated the procedure well, with complete resolution of the radicular leg pain. At a two-year follow up, the patient had a solid fusion without subsidence or recurrence of heterotopic bone. This case represents a novel pattern of heterotopic ossification, and it describes a previously unreported cause for implant failure in lumbar disc replacement surgery-reinforcing the importance of proper intraoperative component positioning. We propose a modification to the existing McAfee classification of HO after TDA with the addition of Class V and VI HO.

Original languageEnglish (US)
Pages (from-to)456-460
Number of pages5
JournalAsian Spine Journal
Volume9
Issue number3
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Total Disc Replacement
Heterotopic Ossification
Radiculopathy
Back Pain
Spinal Canal
Decompression
Reoperation
Osteogenesis
Leg
Tomography
Bone and Bones
Recurrence
Pain

Keywords

  • Heterotopic ossification
  • Radiculopathy
  • Total disc arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Heterotopic ossification causing radiculopathy after lumbar total disc arthroplasty. / Jackson, Keith L.; Hire, Justin M.; Jacobs, Jeremy M.; Key, Charles C.; DeVine, John Glenden.

In: Asian Spine Journal, Vol. 9, No. 3, 01.01.2015, p. 456-460.

Research output: Contribution to journalArticle

Jackson, Keith L. ; Hire, Justin M. ; Jacobs, Jeremy M. ; Key, Charles C. ; DeVine, John Glenden. / Heterotopic ossification causing radiculopathy after lumbar total disc arthroplasty. In: Asian Spine Journal. 2015 ; Vol. 9, No. 3. pp. 456-460.
@article{9729376e7222456a894c550715335a19,
title = "Heterotopic ossification causing radiculopathy after lumbar total disc arthroplasty",
abstract = "To date, no reports have presented radiculopathy secondary to heterotopic ossification following lumbar total disc arthroplasty. The authors present a previously unpublished complication of lumbar total disk arthroplasty (TDA) secondary to heterotopic ossification (HO) in the spinal canal, and they propose a modification to the McAfee classification of HO. The patient had undergone an L5/S1 lumbar TDA two years prior due to discogenic back pain. His preoperative back pain was significantly relieved, but he developed new, atraumatic onset radiculopathy. Radiographs and a computed tomography myelogram revealed an implant malposition posteriorly with heterotopic bone formation in the canal, causing an impingement of the traversing nerve root. Revision surgery was performed with implant extraction, L5/S1 anterior lumbar interbody fusion, supplemental posterior decompression, and pedicle screw fixation. The patient tolerated the procedure well, with complete resolution of the radicular leg pain. At a two-year follow up, the patient had a solid fusion without subsidence or recurrence of heterotopic bone. This case represents a novel pattern of heterotopic ossification, and it describes a previously unreported cause for implant failure in lumbar disc replacement surgery-reinforcing the importance of proper intraoperative component positioning. We propose a modification to the existing McAfee classification of HO after TDA with the addition of Class V and VI HO.",
keywords = "Heterotopic ossification, Radiculopathy, Total disc arthroplasty",
author = "Jackson, {Keith L.} and Hire, {Justin M.} and Jacobs, {Jeremy M.} and Key, {Charles C.} and DeVine, {John Glenden}",
year = "2015",
month = "1",
day = "1",
doi = "10.4184/asj.2015.9.3.456",
language = "English (US)",
volume = "9",
pages = "456--460",
journal = "Asian Spine Journal",
issn = "1976-1902",
publisher = "Korean Society of Spine Surgery",
number = "3",

}

TY - JOUR

T1 - Heterotopic ossification causing radiculopathy after lumbar total disc arthroplasty

AU - Jackson, Keith L.

AU - Hire, Justin M.

AU - Jacobs, Jeremy M.

AU - Key, Charles C.

AU - DeVine, John Glenden

PY - 2015/1/1

Y1 - 2015/1/1

N2 - To date, no reports have presented radiculopathy secondary to heterotopic ossification following lumbar total disc arthroplasty. The authors present a previously unpublished complication of lumbar total disk arthroplasty (TDA) secondary to heterotopic ossification (HO) in the spinal canal, and they propose a modification to the McAfee classification of HO. The patient had undergone an L5/S1 lumbar TDA two years prior due to discogenic back pain. His preoperative back pain was significantly relieved, but he developed new, atraumatic onset radiculopathy. Radiographs and a computed tomography myelogram revealed an implant malposition posteriorly with heterotopic bone formation in the canal, causing an impingement of the traversing nerve root. Revision surgery was performed with implant extraction, L5/S1 anterior lumbar interbody fusion, supplemental posterior decompression, and pedicle screw fixation. The patient tolerated the procedure well, with complete resolution of the radicular leg pain. At a two-year follow up, the patient had a solid fusion without subsidence or recurrence of heterotopic bone. This case represents a novel pattern of heterotopic ossification, and it describes a previously unreported cause for implant failure in lumbar disc replacement surgery-reinforcing the importance of proper intraoperative component positioning. We propose a modification to the existing McAfee classification of HO after TDA with the addition of Class V and VI HO.

AB - To date, no reports have presented radiculopathy secondary to heterotopic ossification following lumbar total disc arthroplasty. The authors present a previously unpublished complication of lumbar total disk arthroplasty (TDA) secondary to heterotopic ossification (HO) in the spinal canal, and they propose a modification to the McAfee classification of HO. The patient had undergone an L5/S1 lumbar TDA two years prior due to discogenic back pain. His preoperative back pain was significantly relieved, but he developed new, atraumatic onset radiculopathy. Radiographs and a computed tomography myelogram revealed an implant malposition posteriorly with heterotopic bone formation in the canal, causing an impingement of the traversing nerve root. Revision surgery was performed with implant extraction, L5/S1 anterior lumbar interbody fusion, supplemental posterior decompression, and pedicle screw fixation. The patient tolerated the procedure well, with complete resolution of the radicular leg pain. At a two-year follow up, the patient had a solid fusion without subsidence or recurrence of heterotopic bone. This case represents a novel pattern of heterotopic ossification, and it describes a previously unreported cause for implant failure in lumbar disc replacement surgery-reinforcing the importance of proper intraoperative component positioning. We propose a modification to the existing McAfee classification of HO after TDA with the addition of Class V and VI HO.

KW - Heterotopic ossification

KW - Radiculopathy

KW - Total disc arthroplasty

UR - http://www.scopus.com/inward/record.url?scp=84933515676&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84933515676&partnerID=8YFLogxK

U2 - 10.4184/asj.2015.9.3.456

DO - 10.4184/asj.2015.9.3.456

M3 - Article

VL - 9

SP - 456

EP - 460

JO - Asian Spine Journal

JF - Asian Spine Journal

SN - 1976-1902

IS - 3

ER -