单节段颈椎人工椎间盘置换术早中期临床疗效探讨  

A clinical study of the early and intermediate stage of single-level cervical disc replacement for cervical spondylosis

作　　者：刘晓冬[1] 朱庆和[1] 丁可[1] 刘长美[1] 柳俊杰[1] 

机构地区：[1]涪陵中心医院骨科,重庆涪陵408000

出　　处：《局解手术学杂志》2010年第3期203-205,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨单节段颈椎人工椎间盘置换术早、中期临床疗效。方法对我院28例颈椎病患者分别经单节段颈椎人工椎间盘置换术、颈椎前路减压钛网植入内固定融合术治疗,13例患者行单节段颈椎人工椎间盘假体置换(B ryan置换组),15例行传统颈前路单节段椎间盘切除减压钛网植骨融合内固定(钛网植入内固定融合组)。术后6周、3个月、6个月、12个月、18个月、24个月进行随访,平均随访21个月。并适时复查拍摄颈椎前屈后伸动力位X线片,观察置换组假体稳定性及融合组融合节段骨性融合情况。同时进行术后系列调查评分,统计并发症发生率,对治疗结果进行回顾性统计分析。结果单节段钛网植入内固定融合手术组术后早期吞咽困难、颈痛、上肢疼痛等发生率比单节段B ryan人工颈椎间盘置换手术组明显要高(P<0.05),单节段钛网植入内固定融合组术后邻近节段的活动度较术前明显增大(P<0.05);而单节段B ryan人工颈椎间盘置换组置换前后邻近节段活动范围无显著性差异(P>0.05)。结论单节段颈椎人工椎间盘置换术后早期并发症减少,中期能保护相邻节段退变,与传统减压钛网植入内固定融合术相比治疗效果有一定提高。Objective To investigate the curative effect of the early and intermediate stage complications of cervical disc arthroplasty.Methods From January 2005 to January 2009,13 patients with cervical spondylosis were treated with single-level cervical disc replacement,and 15 patients with cervical spondylosis were treated with traditional anterior cervical discectomy and fusion CACDF group.At 6 weak,3,6,12,18 and 24 months after operation,the patients were followed up.The radiography of forward flexion,backward extension,and left and right lateral flexion was obtained at every follow-up time.The stability of prosthesis,the range of motion status at operated level in Bryan group and the fusion in ACDF group were observed.Meanwhile,investigate all patients with complications by follow-up score.Results All patients with 18 months to 24 months follow-up（average 21 months）,The X-ray films of 15 patients treated with traditional anterior cervical discectomy and fusion showed good intervertebral fusion.Complications of 13 patients treated with single-level Bryan cervical disc replacement were obviously not so many as of 15 patients treated with traditional anterior cervical discectomy and fusion（P0.05）.The range of motion postoperative on adjacent segments was increased obviously than preoperative in ACDF group（P0.05）,but there were no significant differences in Bryan group before and after replacement（P0.05）.Conclusion Compared with traditional anterior cervical discectomy and fusion,Byran disc arthroplasty for cervical syndrome exhibits good mid-term outcomes.Moreover,the motion at operated level is preserved and the increase of range of motion on adjacent segments postoperative is avoided.

关 键 词：颈椎病 人工椎间盘 置换 

分 类 号：R681.55[医药卫生—骨科学]