Journal article
Proposal for a classification system of radiographic bone changes after cervical disc replacement
Journal of orthopaedic surgery and research, v 19(1), pp 218-218
03 Apr 2024
PMID: 38566203
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The goal of this study is to propose a classification system with a common nomenclature for radiographic observations of periprosthetic bone changes following cTDR.
Aided by serial plain radiographs from recent cTDR cases (34 patients; 44 devices), a panel of experts assembled for the purpose of creating a classification system to aid in reproducibly and accurately identifying bony changes and assessing cTDR radiographic appearance. Subdividing the superior and inferior vertebral bodies into 3 equal sections, observed bone loss such as endplate rounding, cystic erosion adjacent to the endplate, and cystic erosion not adjacent to the endplate, is recorded. Determining if bone loss is progressive, based on serial radiographs, and estimating severity of bone loss (measured by the percentage of end plate involved) is recorded. Additional relevant bony changes and device observations include radiolucent lines, heterotopic ossification, vertebral body olisthesis, loss of core implant height, and presence of device migration, and subsidence.
Serial radiographs from 19 patients (25 devices) implanted with a variety of cTDR designs were assessed by 6 investigators including clinicians and scientists experienced in cTDR or appendicular skeleton joint replacement. The overall agreement of assessments ranged from 49.9% (95% bootstrap confidence interval 45.1-73.1%) to 94.7% (95% CI 86.9-100.0%). There was reasonable agreement on the presence or absence of bone loss or radiolucencies (range: 58.4% (95% CI 51.5-82.7%) to 94.7% (95% CI 86.9-100.0%), as well as in the progression of radiolucent lines (82.9% (95% CI 74.4-96.5%)).
The novel classification system proposed demonstrated good concordance among experienced investigators in this field and represents a useful advancement for improving reporting in cTDR studies.
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Details
- Title
- Proposal for a classification system of radiographic bone changes after cervical disc replacement
- Creators
- Armen Khachatryan - Desert Institute For Spine CareFrank M Phillips - Rush University Medical CenterTodd H Lanman - Lanman Spinal Neurosurgery, Los Angeles, CA, USAGunnar B Andersson - Rush University Medical CenterJoshua J Jacobs - Rush University Medical CenterSteven M Kurtz - Drexel University
- Publication Details
- Journal of orthopaedic surgery and research, v 19(1), pp 218-218
- Publisher
- Springer BMC
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- School of Biomedical Engineering, Science, and Health Systems
- Web of Science ID
- WOS:001197264900001
- Scopus ID
- 2-s2.0-85189198638
- Other Identifier
- 991021866854704721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Orthopedics