Bryan人工间盘置换治疗颈椎病近期疗效及并发症分析  

Analysis of Short Term Outcome and Complications of Bryan Artificial Disc Replacement in the Treatment of Cervical Spondylosis

作　　者：林斌[1,2] 冯万立[1,2] 郭志民[1,2] 刘庆军[1,2] 

机构地区：[1]解放军第175医院骨科医院 [2]厦门大学附属东南医院全军创伤骨科中心,福建漳州363000

出　　处：《实用骨科杂志》2011年第3期193-196,共4页Journal of Practical Orthopaedics

摘　　要：目的评估Bryan人工颈椎间盘置换术治疗颈椎病的近期疗效,分析容易出现的并发症,探讨其原因及相应对策。方法 2008年1月至2009年10月,共完成25例单节段Bryan人工颈椎间盘置换术,其中男16例,女9例;年龄35～51岁,平均42.4岁。脊髓型颈椎病12例,神经根型颈椎病8例,混合型5例。结果全部病例随访9～22个月,平均15个月。脊髓型颈椎病患者术前JOA评分为(8.5±1.0)分,末次随访时为(15.5±1.0)分,与术前比较有显著性差异(P<0.01)。颈痛视觉评分、颈肩障碍疼痛指数与术前相比均具有统计学意义(P<0.05)。神经根型颈椎病患者的症状完全消失。所有病例未见假体下沉、移位以及症状加重者。1例患者术后11个月随访时发现假体周围有异位骨化形成,2例术后置换节段出现后凸。结论 Bryan人工颈椎间盘置换术治疗颈椎间盘疾患可取得良好的临床疗效,但由于其手术操作较为复杂,存在特有的并发症,应重视手术适应证的选择和规范的手术操作。Objective To evaluate the clinical outcome of Bryan artificial disc replacement in the treatment of cervical spondylosis,and investigate the cause of some complications and correlated solutions.Methods From January 2008 to October 2009,25 patients（16 males and 9 females） underwent Bryan artificial disc replacement.The average age was 42.4 years（range,35～51years）.Among these cases,there are cervical spondylotic myelopathy 12 cases,cervical spondylotic radiculopathy 8 cases,mixed cervical spondylosis 5 cases.Results All cases obtained the follow-up with an average of 15 months（range 9 to 22 months）.The pre-operative JOA score was（8.5±1.0） and post-operative was（15.5±1.0） on an average in the cases of spondylotic myelopathy（P0.01）.VAS and NDI scores showed significant differences afterreplacement（P0.05）.All symptoms disappeared in the cases of radiculopathy.There was no subsidence of implant and worsening of pre-operative symptoms.One case showed heterotopic ossification in 11 months.Two cases had the segmental kyphotic change after surgery.Conclusion The Bryan cervical disc replacement for the treatment of cervical spondylosis has offered an excellent short term clinical outcome.But the procedure is much complicated and has its special complications,so the surgical indications and correct manipulations should be chosen properly.

关 键 词：BRYAN 人工颈椎间盘置换术 颈椎病 并发症 

分 类 号：R681.55[医药卫生—骨科学]