Prodisc—C人工颈椎间盘置换术和前路减压融合术治疗单节段颈椎病的效果比较  

Comparison of the effect of the Prodisc-C cervical disc prosthesis and anterior cervical discectomy and fu- sion in one level cercical spoudyiosis

作　　者：王伟炎[1] 刘海鹰[1] 王波[1] 王会民[1] 

机构地区：[1]北京大学人民医院脊柱外科,100044

出　　处：《中国医药》2013年第9期1271-1273,共3页China Medicine

摘　　要：目的分析比较Prodisc—C人工颈椎间盘置换术和颈椎前路减压融合术（ACDF）治疗单节段颈椎病的临床效果。方法对47例颈椎病患者进行手术治疗，其中23例行Prodisc-C人工颈椎间盘置换，24例行单节段ACDF，进行临床随访，对比分析2组患者手术前后的临床及影像学资料。主要观察指标：视觉模拟评分（VAS），颈椎功能障碍指数（NDI），SF-36健康调查评分。运用McAfee分级法评估置换节段异位骨化情况，动态x线测量手术节段活动度。结果Prodisc．C组和ACDF组患者术前颈痛VAS分别为（7．0±1．0）、（6．6±1．4）分，术后5年随访颈痛VAS分别为（2．1-t-O．9）、（2．9±0．9）分，2组患者术后VAS分别与术前比较，差异有统计学意义（P〈0．05），2组患者术后VAS比较，差异有统计学意义（P〈0．05）。Prodisc．C组患者术前NDI为（54±13）分，ACDF组为（54±11）分；术后5年随访NDl分别为（20±8）、（23±6）分，2组患者较术前均有明显好转，2组患者术后与术前比较，差异均有统计学意义（P〈0．05）；2患者术后5年NDI比较，差异无统计学意义差异（P〉0．05）。Prodisc．C组术前、术后5年ROM分别为（8．4±0．6）。、（8．1±0．6）。，差异无统计学意义（P〉0．05）；ACDF组术前为（7．8±0．6）。，术后5年为（1．1±0．3）。，术后手术节段活动度明显降低，差异有统计学意义（P〈0．05）；2组患者术后ROM比较，差异有统计学意义（P〈0．05）。结论Prodisc．C颈椎人工间盘置换的5年随访临床效果优良，为治疗单节段颈椎病安全有效术式选择之一。Objective To evaluate the efficacy of cervical total disc replacement（TDR） with Prodisc-C and anterior cervical discectomy and fusion （ACDF）. Methods Forty-seven patients with cervical symptomatic disc dis- ease underwent implantation with the Prodisc-C prosthesis or MC ＋ fusion after anterior cervical diseectomy. At the follow-up periods, the clinical outcome was evaluated by Visual Analogue Score（VAS）. The Neck Disability Index （NDI） and SF-36, radiographical evaluation include Range of Motoon （ROM） of the implanted level. Results All the patients were assessed 5 years after surgery, VAS scores of Pre-Op of Prodisc-C was （7.0 ~ 1. O） score, ACDF was（6.6 ~ 1.4） score ; 5 years Post-Op of Prodise-C was （2. I ＋ 0.9） score, ACDF was （2.9 ~ 0.9） score, Pro- Disc-C patients had statistically significantly less neck pain（ P 〈 0.05 ） ; At 5 years, NDI and SF-36 scores were sig- nificantly improved compared with preoperative scores. Heterotopic ossification in 13 Prodisc-C patients occurred, accounted for 56.5%. There were no reports of device failures or implant migration in both groups. Conclusion The results of this clinical series demonstrate that TDR with Prodisc-C is a safe and effective surgical treatment for pa- tients with disabling single level cervical disease.

关 键 词：颈椎病 人工间盘置换 前路减压融合术 

分 类 号：R681[医药卫生—骨科学]