{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T09:01:19Z","timestamp":1780736479270,"version":"3.54.1"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>This study aimed to investigate the incidence rate of heterotopic ossification (HO) after implantation of Coflex interspinous devices. Possible risk factors associated with HO were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The authors retrospectively analyzed patients who had undergone single-level (L4\u20135) implantation of a Coflex device for the treatment of lumbar spinal stenosis. Patient data recorded were age, sex, height, weight, body mass index, smoking habits, and surgical time. Heterotopic ossification was identified through lumbar anteroposterior and lateral view radiographs. The authors developed a simple classification for defining HO and compared HO-positive and HO-negative cases to identify possible risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 32 patients with follow-up times of 24\u201357 months, HO was detectable in 26 (81.2%). Among these 26 patients, HO was in the lateral space of the spinous process but not in the interspinous space in 8, HO was in the interspinous space but did not bridge the adjacent spinous process in 16, and interspinous fusion occurred at the level of the device in 2. Occurrence of HO was not associated with patient age, sex, height, weight, body mass index, smoking habits, or surgical time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A high incidence of HO has been detected after implantation of Coflex devices. Clinicians should be aware of this possible outcome, and more studies should be conducted to clarify the clinical effects of HO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2013.3.focus12406","type":"journal-article","created":{"date-parts":[[2013,8,1]],"date-time":"2013-08-01T09:59:17Z","timestamp":1375351157000},"page":"E3","source":"Crossref","is-referenced-by-count":10,"title":["Incidence of heterotopic ossification after implantation of interspinous process devices"],"prefix":"10.3171","volume":"35","author":[{"given":"Nai-Feng","family":"Tian","sequence":"first","affiliation":[{"name":"Zhejiang Spine Research Center, Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai-Min","family":"Wu","sequence":"additional","affiliation":[{"name":"Zhejiang Spine Research Center, Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Jun","family":"Wu","sequence":"additional","affiliation":[{"name":"Institute of Digitized Medicine, Wenzhou Medical College, Wenzhou, Zhejiang, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin-Lei","family":"Wu","sequence":"additional","affiliation":[{"name":"Institute of Digitized Medicine, Wenzhou Medical College, Wenzhou, Zhejiang, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao-Sen","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Lei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Zhejiang Spine Research Center, Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua-Zi","family":"Xu","sequence":"additional","affiliation":[{"name":"Zhejiang Spine Research Center, Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Long","family":"Chi","sequence":"additional","affiliation":[{"name":"Zhejiang Spine Research Center, Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical College;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0350003","series-title":"J Arthroplasty","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.arth.2007.11.008","article-title":"Aspirin decreases the prevalence and severity of heterotopic ossification after 1-stage bilateral total hip arthroplasty for osteoarthrosis","volume":"24","author":"Bek","year":"2009"},{"key":"b2-0350003","series-title":"J Bone Joint Surg Br","first-page":"434","article-title":"The prophylaxis and treatment of heterotopic ossification following lower limb arthroplasty","volume":"89","author":"Board","year":"2007"},{"key":"b3-0350003","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1097\/BSD.0b013e3180331352","article-title":"Interspinous process devices in the lumbar spine","volume":"20","author":"Bono","year":"2007"},{"issue":"6","key":"b4-0350003","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E8","DOI":"10.3171\/2010.3.FOCUS1047","article-title":"Dynamic interspinous process stabilization: review of complications associated with the X-Stop device","volume":"28","author":"Bowers","year":"2010"},{"key":"b5-0350003","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1007\/s00586-011-2094-x","article-title":"Prevalence of heterotopic ossification after cervical total disc arthroplasty: a meta-analysis","volume":"21","author":"Chen","year":"2012"},{"issue":"16 Suppl","key":"b6-0350003","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"S73","DOI":"10.1097\/01.brs.0000174532.58468.6c","article-title":"Dynamic interspinous process technology","volume":"30","author":"Christie","year":"2005"},{"key":"b7-0350003","series-title":"J Am Acad Orthop Surg","doi-asserted-by":"publisher","first-page":"409","DOI":"10.5435\/00124635-200211000-00005","article-title":"Heterotopic ossification after hip and knee arthroplasty: risk factors, prevention, and treatment","volume":"10","author":"Iorio","year":"2002"},{"key":"b8-0350003","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E1499","DOI":"10.1097\/BRS.0b013e3181e9af93","article-title":"Lumbar interspinous spacers: a systematic review of clinical and biomechanical evidence","volume":"35","author":"Kabir","year":"2010"},{"key":"b9-0350003","series-title":"J Iowa State Med Soc","first-page":"551","article-title":"The Knowles vertebral support operation","volume":"48","author":"Knowles","year":"1958"},{"key":"b10-0350003","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1227\/01.NEU.0000175856.31210.58","article-title":"Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial","volume":"57","author":"Leung","year":"2005"},{"key":"b11-0350003","series-title":"Case Rep Surg","first-page":"970642","article-title":"Heterotopic ossification in vertebral interlaminar\/interspinous instrumentation: report of a case","volume":"2012","author":"Maida","year":"2012"},{"key":"b12-0350003","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1097\/00024720-200308000-00010","article-title":"Classification of heterotopic ossification (HO) in artificial disk replacement","volume":"16","author":"McAfee","year":"2003"},{"key":"b13-0350003","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"210","DOI":"10.3171\/2009.9.SPINE09144","article-title":"Erosion of the spinous process: a potential cause of interspinous process spacer failure. 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