Cervical Total Disc Replacement: Heterotopic Ossification and Complications

  • Michael Paci
  • Michael Y. WangEmail author
Living reference work entry


Cervical total disc replacement (CTDR) can be complicated by the occurrence of heterotopic ossification (HO). HO occurs when bone formation happens in tissues where it is not normally present. It is graded radiographically and develops on a spectrum, from ossification anterior to the cervical spine to ossification involving the articulating surfaces and causing an effective fusion. The true incidence of HO after CTDR is still under debate, with rates reported in the literature varying from approximately 20–90% of patients. The exact causes of HO are still unknown, but associations have been found with male gender, older age, type of prosthesis used, multilevel surgery, and surgical technique. The presence of HO after CTDR has not been correlated with worse clinical outcomes. There is no evidence to date to support a specific strategy to prevent HO, but prescribing a short course of nonsteroidal anti-inflammatory drugs (NSAIDs) is often done. CTDR is also associated with other complications, including complications that can occur during the anterior approach to the cervical spine, complications related to the prosthesis used and adjacent segment disease.


Cervical disc replacement Heterotopic calcification Anterior cervical approach Prosthesis-related complication Adjacent segment disease 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Neurological SurgeryUniversity of Miami Miller School of MedicineMiamiUSA

Section editors and affiliations

  • Domagoj Coric
    • 1
    • 2
  1. 1.Department of Neurological SurgeryCarolinas Medical CenterCharlotteUSA
  2. 2.Carolina Neurosurgery and Spine AssociatesCharlotteUSA

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