双节段BRYAN人工颈间盘置换的中期疗效分析  

Medium term efficacy analysis of bi-level BRYAN artificial cervical disc replacement for the treatment of cervical spondylosis

作　　者：种涛[1] 俞兴[1] 贾育松[1] 李春根[1] 柳根哲[1] 毕连涌[1] 徐林[1] 

机构地区：[1]北京中医药大学东直门医院骨科,北京市东城区海运仓5号100700

出　　处：《中国矫形外科杂志》2013年第1期23-28,共6页Orthopedic Journal of China

摘　　要：[目的]观察相邻双节段BRYAN人工颈椎间盘置换术治疗相邻节段颈椎病的临床疗效与影像学结果。[方法]回顾2006年1月～2009年2月在本院行相邻双节段BRYAN人工颈椎间盘置换术并获得随访的颈椎病患者19例。术前及术后1周,术后3、6、12、24、36个月进行JOA评分、NDI评分及颈痛VAS评分,评估手术临床疗效;术前及术后3、6、12、24、36个月通过颈椎动力位X线片评定置换节段、上下相邻节段和C2～7颈椎活动度;术后12、24、36个月,通过X线椎间盘退变评分系统评估手术相邻节段退变。[结果]所有患者术后神经症状均明显好转,各随访点JOA评分、NDI评分、颈痛VAS评分较术前显著改善,差异有统计学意义(P<0.05),3个月后各随访时点两两比较差异无统计学意义(P>0.05)。两置换节段活动度术后各随访点与术前比较差异有统计学意义(P<0.05);3个月后随访,上下相邻节段活动度与术前相比略减小,C2～7活动度较术前略增加,差异无统计学意义(P>0.05)。至末次随访时,手术未导致相邻节段椎间盘退变加剧,无严重并发症发生。[结论]BRYAN人工颈椎间盘置换治疗相邻双节段颈椎间盘退变性疾病临床疗效良好,不仅保留了颈椎的运动学特性,防止置换节段与相邻节段退变,而且术后近中期无严重并发症。[ Objective] To observe the clinical effect and imaging results of the treatment of adjacent segment cervical spondylosis in the adjacent bilevel BRYAN cervical disc replacement. [ Method] A retrospective studying was performed on 19 cases of cervical spondylosis receiving adjacent bi - level BRYAN artificial cervical disc replacement and were followed up from January 2006 to February 2009 in our hospital. Clinical outcome of surgery was evaluated by Japanese Orthopaedic Association score （JOA）, neck disability index（NDI） and visual analogue pain scale （VAS）for neck pain before surgery and at 1 week, 3, 6,12,24,36 months after surgery respectively. The range of motion （ROM） of the surgical segments, the upper and lower adja- cent segments, and C2_7 was assessed by cervical dynamic X - ray film before operation and 3,6,12,24,36 months after sugery. Operative adjacent segment degeneration was assessed by X - ray disc degeneration scoring system 12,24 and 36 months after surgery. [ Result] The neurological symptoms of each patients were significantly improved. The postoperative JOA score , NDI scores, neck pain VAS scores were improved significantly at each follow - up time point compared with those of preoperation, difference was statistically significant （P 〈 0.05 ）, but no statistical significance were noted between each time point after 3 - month follow - up （P 〉 0.05 ）. ROM of the two operative segment increased significantly compared with the preoperative each time point after 3 - month follow - up （ P 〈 0.05 ）. ROM of the upper and lower adjacent segments slightly reduced and C2-7 slightly increased but both showed no statistical significance compared with the preoperative between each time point after 3 - month follow- up（ P 〉 0.05 ）. To the last follow-up, the surgery had not led to adjacent segment disc degeneration exacerbated and no serious complications occurred. [ Conclusion ] The clinical result of BRYAN artificial cervical disc replacement in the treatment of a

关 键 词：颈椎病 双节段 人工颈椎间盘 疗效 活动度 

分 类 号：R687.3[医药卫生—骨科学]