Two years ago, I had a cervical disc replacement at C45. Just had my check-up and everything looks good. The surgeon said there was no “ossification” (bone build-up). If I don’t have this problem by now, does it mean I am safe from it?

Ossification refers to the formation of bone within soft tissue structures such as muscles and ligaments. It develops after surgeries that involve cutting or disrupting the soft tissues (e.g., muscles, tendons, ligaments) around bone anywhere in the body.

The exact cause of ossification isn’t quite clear. It could be part of the healing response of the soft tissues after being cut and moved away from the bones. There is some thought that pins or screws used in orthopedic procedures (like spinal fusion) might generate this type of response.

Changing the biomechanics of the spinal segment may have a role in the development of ossification. Some researchers are looking at the amount of pressure inside the discs (called intradiscal pressure) as a possible contributing factor.

Not everyone develops ossification. When they do, there aren’t always any symptoms (such as pain) or obvious effects (further loss of motion). So just how much of a problem this problem is remains under investigation.

There is some research to support the idea that if you haven’t developed ossification after 12 months (and especially after 24 months), then your risk decreases considerably. Efforts are underway to figure out just why ossification develops, who it is most likely to occur in, and ways to prevent its development.