27例单节段Bryan颈椎间盘假体置换临床研究  

Single-level Bryan disc prosthesis replacement for cervical arthroplasty: clinical report of 27 cases

作　　者：张雪松[1] 王岩[1] 肖嵩华[1] 陆宁[1] 

机构地区：[1]中国人民解放军总医院骨科,北京100853

出　　处：《中国微侵袭神经外科杂志》2005年第9期393-395,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的观察单节段Bryan颈椎间盘假体置换术后的稳定性和植入节段的活动度,评价早期治疗效果。方法对27例脊髓型颈椎病病人行Bryan颈椎间盘假体置换术。手术前和术后6个月进行JOA评分,术后6个月进行Odom评级;术后3、6个月随访时摄置换节段前屈后伸位、左右侧屈位X-线片。术后6个月进行置换间隙CT扫描。结果经1￣10个月随访,病人术后症状均明显缓解。随访时间超过6个月者10例;JOA评分由术前平均8.9分(7￣13分)上升至术后平均15.7分(14￣17分);Odom评级7例优,3例良。X-线检查未发现偏移或假体下沉,置换节段前屈后伸活动度平均5.71°(5.0°￣6.9)°;左右侧屈活动度分别为平均3.5°(2.5￣°4.8)°和3.4°(2.4°￣4.8)°。术后6个月置换间隙CT扫描示假体上、下金属壳偏离中央2例,金属终板的骨长入良好。结论颈人工椎间盘置换术可保持前路减压的良好效果,同时取得了良好的术后即刻稳定性,维持了颈椎的正常活动度。Objective To observe the stability and range of motion （ROM） of implanted disc prosthesis after single-level Bryan disc replacement, and evaluate early clinical effects of cervical arthroplasty. Methods Single-level Bryan disc prosthesis was applied to 27 patients with cervical spondylotic myelopathy. JOA score was made at preoperation and 6 months postoperatively and Odom＇s scale was also done at the 6th month after operation. Radiography （forward flexion, backward extension; fight and left lateral bending） was performed at the 3rd and 6th month of follow-up after the operation respectively. ROM of the replaced level was measured, and CT scan was carried out at 6th month after the operation, Results Patients were followed up for l to 10 months, and significant symptom relief was achieved in all the patients. Ten patients were followed up at least 6 months, and the JOA score increased from average 8.9 （7-13） to 15.7 （14-17）. According to the Odom＇s scale, 7 patients achieved excellent, and 3 achieved good results. Replaced segment achieved stability and a ROM with 5.71 ° （5.0°-6.9°） in flexion and extension, and 3.47° （2.5°-4.8°）, 3.42° （2.4°-4.8°） respectively in fight and left bending. Good bone incorporation was found around metal end plate of the prosthesis. Conclusion Single level cervical arthroplasty can achieve good outcome of anterior decompression and immediate stability postoperation, and normal ROM can be kept at the implanted site.

关 键 词：椎间盘 假体和植人物 关节成形术 

分 类 号：R687.4[医药卫生—骨科学]