椎间隙高度对Prestige LP颈椎间盘置换术后活动度和疗效的影响  

Effect of Intervertebral Height on Postoperative Motion and Clinical Outcomes after Single Segment Prestige LP Cervical Arthroplasty

作　　者：娄纪刚 刘浩[1] 龚全[1] 戎鑫[1] 李会波[1] 孟阳[1] 武文杰[1] 

机构地区：[1]四川大学华西医院骨科,四川成都610041

出　　处：《实用骨科杂志》2015年第4期289-292,共4页Journal of Practical Orthopaedics

摘　　要：目的：分析术前、术后椎间隙高度对单节段 Prestige LP 人工颈椎间盘置换术后置换节段活动度和临床效果的影响。方法2008年2月至2013年4月，63例患者在我院行 Prestige LP 人工颈椎间盘单节段置换术，其中男31例，女32例；年龄28~68岁，平均47.6岁。神经根型颈椎病32例，脊髓型颈椎病25例，混合型颈椎病6例。置换节段：C3~41例，C4 ~ 5 5例，C5~652例，C6~74例，C7 T11例。收集患者术前及术后门诊随访时颈椎正侧位及功能位 X 线片，利用 CANVAS 软件测量术前、术后椎间隙高度和目标节段屈伸活动度（range of motion，ROM），临床效果评价采用JOA 评分和 NDI 评分。研究术前、术后椎间隙高度对术后置换节段活动的影响，并进行椎间隙高度与术后置换节段活动度和临床效果的相关性分析。结果人工颈椎间盘置换术后置换节段 ROM 为（10.8±3.2）°;，术前置换关节ROM 为（10.4±3.3）°，差异无统计学意义（P〉0.05）；术后置换节段椎间隙高度为（7.0 ± 0.9）mm，术前椎间隙高度为（4.6±1.0）mm，差异有统计学意义（P〈0.05）。术前椎间隙高度小于4.0 mm 的患者，人工颈椎间盘置换术后置换节段 ROM 相比术前平均增加0.7°（P〈0.05）；而术前椎间隙高度大于4.0 mm 的患者，术后置换节段 ROM 与术前相比差异无统计学意义（P〉0.05）。术后置换节段椎间隙高度大于6 mm 的患者术后 ROM 平均为11.3°，术后椎间隙高度小于6 mm 的患者术后 ROM 平均为8.8°，差异有统计学意义（P〈0.05）；而两组间术后 JOA 评分、NDI 评分差异均无统计学意义（P〉0.05）。术后置换节段椎间隙高度小于8 mm 的患者术后 ROM 平均为11.2°，术后椎间隙高度大于8 mm 的患者术后 ROM 平均为9.1°，差异有统计学意义（P〈0.05）；两组间术后 JOA 评分、NDI 评分则差异无统计学意义（P〉0.05）。术前、术后椎间隙高度与术�Objective To analyze the influence of pre-and postoperative disc height on postoperative range of motion （ROM）and clinical outcomes after single segment Prestige LP cervical disc replacement. Methods 63 cases underwent sin-gle segment Prestige LP cervical disc replacement from February 2008 to April 2013. All patients were examined on lateral and flexion-extension radiographs. The intervertebral height and flexion-extension ROM were measured by the CANVAS,and the clinical outcomes were evaluated by Japanese Orthopaedic Association（JOA）and Neck Disability Index（NDI）. The influence of pre-and postoperative disc height on postoperative ROM was investigated,and the correlation between the disc height and postoperative ROM or clinical outcomes was analyzed. Results The postoperative segmental ROM was（10. 8 ± 3. 2）°,the preoperative segmental ROM was（10. 4 ± 3. 3）°; without statistical significance（P ＆gt; 0. 05）. The postoperative disc height was （7. 0 ± 0. 9）mm,the preoperative disc height was（4. 6 ± 1. 0）mm with statistical significance（P〈0. 05）. Patients with less than 4 mm of preoperative disc height had a mean 0 . 7 ° increase in flexion - extension ROM after cervical arthroplasty（ P〈0. 05）,whereas patients with greater than 4 mm of preoperative disc height had no change in flexion-extension ROM（P〉0. 05）. The postoperative ROM of patients with greater than 6 mm of postoperative disc height was 11. 3°,the postoperative ROM of those with less than 6 mm of postoperative disc height was 8. 8° with statistical significance（P〈0. 05）. The postoperative ROM of patients with less than 8 mm of postoperative disc height was 11. 2°,the postoperative ROM of those with greater than8 mm of postoperative disc height was 9. 1° with statistical significance（P〈0. 05）,however,there is no significant difference in postoperative JOA and NDI between them（P〈0. 05）. No correlation could be found between disc height and the postopera-tive ROM、JOA or NDI. Con

关 键 词：人工颈椎间盘置换术 椎间隙高度 活动度 临床效果 

分 类 号：R681.55[医药卫生—骨科学]