单节段ProDisc-C颈椎人工椎间盘置换术对颈椎曲度和活动度的影响  

Cervical alignment and range of motion after single-level ProDisc-C replacement

作　　者：赵衍斌 孙宇[1] 张凤山[1] 陈仲强[1] 刘忠军[1] 

机构地区：[1]北京大学第三医院骨科,北京市100083

出　　处：《中国脊柱脊髓杂志》2010年第8期677-680,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:观察单节段ProDisc-C颈椎人工椎间盘置换术后置换节段活动度和颈椎曲度变化情况,分析ProDisc-C人工椎间盘置换术的效果。方法:2006年6月～2008年9月对53例颈椎病患者行单节段前路减压、ProDisc-C人工椎间盘置换术,置换节段C3/47例,C4/510例,C5/627例,C6/79例。应用医学影像存储与传输系统(PACS)测量术前和末次随访时置换节段活动度(ROM)、置换节段脊柱功能单位(functional spinal unit,FSU)Cobb角和颈椎整体曲度(C2～C7Cobb角)。结果:随访3～36个月,平均13.8个月。术前置换节段ROM为8.6°±3.7°,末次随访时为9.7°±3.5°,有统计学差异(P<0.05);术前FSUCobb角(前凸为正值)为0.1°±4.8°,末次随访时为3.6°±4.5°,有统计学差异(P<0.05);术前颈椎整体曲度为7.0°±10.2°,末次随访时为8.0°±10.4°,无统计学差异(P>0.05)。结论:单节段ProDisc-C颈椎人工椎间盘置换术后置换节段活动度较术前增大,颈椎整体曲度无明显变化,FSU前凸增大,对于术前病变节段FSU生理前凸变小或轻度后凸的拟行颈椎人工椎间盘置换的患者可选择ProDisc-C假体。Objective：To investigate the cervical alignment and range of motion（ROM） after single-level ProDisc-C replacement.Method：53 patients underwent single-level anterior cervical decompression and ProDisc-C replacement between June 2006 and September 2008.There were 7 cases of C3/4,10 cases of C4/5,27 cases of C5/6 and 9 cases of C6/7 involved respectively.Segmental ROM,angular variation at functional spinal unit（FSU）,Cobb angle of lordosis from C2 to C7 were measured and compared on dynamic Xrays by picture archive communication system（PACS）.Result：The follow-up averaged 13.8 months（range,336 months）.The segmental ROM was 8.6°±3.7° and 9.7°±3.5° for baseline and final follow-up respectively with statistical significance（P0.05）.The angular variation at FSU was 0.1°±4.8° and 3.6°±4.5° for baseline and final follow-up respectively with statistical significance（P0.05）.The lordosis Cobb angle of C2-C7 was 7.0°±10.2° and 8.0°±10.4° for baseline and final follow-up respectively without statistical significance（P 0.05）.Conclusion：After single-level ProDisc-C replacement,increase of segmental ROM,maintaining of cervical alignment as well as the increased FSU lordosis are evidenced.The ProDisc-C prosthesis is recommended for the candidates with decreased lordosis or slight FSU kyphosis.

关 键 词：人工椎间盘置换术 ProDisc-C 脊柱功能单位角度 颈椎曲度 颈椎活动度 

分 类 号：R681.5[医药卫生—骨科学] R318.17[医药卫生—外科学]