人工颈椎间盘假体置换短期随访:颈椎稳定性及其运动范围变化  

Short-term follow-up for artificial cervical disc replacement:Changes of stability and range of motion in cervical vertebra

作　　者：汤雪明[1] 徐南伟[1] 周栋[1] 蒋巍[1] 李海波[1] 

机构地区：[1]常州市第二人民医院骨科,江苏省常州市213000

出　　处：《中国组织工程研究》2012年第9期1551-1554,共4页Chinese Journal of Tissue Engineering Research

摘　　要：背景:椎间盘摘除减压后的节段融合会限制节段的生理运动,造成邻近节段应力加大而导致其退变加速。目的:观察人工颈椎间盘植入假体治疗颈椎病短期随访中的稳定性及置换节段和颈椎整个节段的运动范围变化。方法:于2010-06/2011-08在常州市第二人民医院骨科共施行PCM钴铬合金颈椎间盘假体置换11例12个节段,男7例,女4例;脊髓型颈椎病8例,外伤性颈椎间盘突出3例。结果与结论:患者随访时间为3～12个月。置换后1,3,6个月以及末次随访时置换节段过屈过伸活动度、左右侧屈活动度与术前接近。置换后1个月、末次随访时患者日本矫形外科协会评分明显升高,而Oswestry颈椎功能障碍指数明显降低(P<0.05),且末次随访时日本矫形外科协会评分和Oswestry颈椎功能障碍指数与术后1个月时差异无显著性意义(P>0.05),同时X射线未发现假体松动、下沉或异位骨化等不良反应。提示PCM人工颈椎间盘置换后短期颈椎稳定功能活动效果较好。BACKGROUND：Segment fusion after the discectomy decompression of cervical disc limits the physical exercise of the segment,which causes the accelerated degeneration due to increased stress of adjacent segment.OBJECTIVE：To observe stability and range of motion （ROM） in the replacement segment and cervical segment during short-term follow-up using artificial cervical disc replacement for the treatment of cervical disc disease.METHODS：Totally 11 cases （12 segments） who treated with cobalt-chromium alloy PCM cervical disc replacement from Department of Orthopedics,the Second People’s Hospital of Changzhou from June 2010 to August 2011 PCM were selected including seven males and four females.Among these cases,there were eight cases with cervical myelopathy,and three cases with traumatic cervical disc herniation.RESULTS AND CONCLUSION：All cases were followed-up for 3 to 12 months.ROM over flexion and extension,and flexion ROM on lateral left and right were similar to preoperation at 1,3,6 months and final follow-up after replacement.Japanese orthopaedic association （JOA） score at 1 month and final follow-up was significantly increased and Oswestry neck disability index （ONDI） was significantly decreased （P〈0.05）.There was no difference of JOA score and ONDI between final follow-up and at postoperative 1 month （P〉0.05）.At the same time,X-ray showed there were no adverse reactions in prosthesis loosening,subsidence or heterotopic ossification.It is indicated that short-term clinical effect for functional motion of cervical vertebra is satisfactory after PCM cervical disc replacement.

关 键 词：钴铬合金颈椎间盘假体 颈椎病 人工颈椎间盘置换 临床效果 医学植入物 组织工程 

分 类 号：R318[医药卫生—生物医学工程]