颈椎动态稳定器在颈椎病外科治疗中的应用  

Application of dynamic cervical implant in the surgical treatment of cervical spondylosis

作　　者：刘进平[1] 赵冬冬[1] 冯海龙[1] 

机构地区：[1]四川省医学科学院.四川省人民医院神经外科,四川成都610072

出　　处：《实用医院临床杂志》2015年第3期17-21,共5页Practical Journal of Clinical Medicine

摘　　要：目的：评价颈椎动态稳定器（dynamic cervical implant，DCI）应用于颈椎病外科治疗的临床疗效，探讨其手术的适应症及安全性。方法2012年3月至2014年2月应用颈椎间盘摘除术＋DCI植入术治疗29例颈椎病患者。其中脊髓型颈椎病23例，神经根型颈椎病6例。术前、术后均采用日本骨科学会（ JOA）评分、颈椎残障功能量表（ NDI）评分、疼痛视觉模拟评分（ VAS）评价临床效果。比较DCI植入节段活动度（ ROM）、C2～7 ROM以及椎间隙高度（ DHI）。结果所有患者均获得12～24个月随访（平均16．5个月）。 DCI植入术后患者JOA、VAS、NDI评分均较术前改善（ P＜0．05）；术后DHI增加，并在随访期间未见丢失（ P＜0．05）。结论 DCI植入术可以恢复DHI，对目标节段进行弹性的动态固定，从而使手术节段活动性得到一定程度的保留，是前路非融合技术治疗颈椎病的良好选择之一。 DCI植入术还可以与人工椎间盘置换（ TDR）、颈椎前路减压融合术（ ACDF）联合应用，其适应证较广，手术操作简单，疗效可靠。Objective To evaluate the clinical outcome of dynamic cervical implant （ DCI） in the surgical treatment of cervical spondylosis ,and to discuss its safety and indications .Methods Twenty-nine patients with cervical spondylosis were treated with cervi-cal discectomy plus DCI implantation from March ,2012 to February,2014.Of the 29 cases,23 were diagnosed as cervical spondylotic myelopathy and 6 as cervical spondylotic radiculopathy .The clinical outcome was evaluated by comparisons of the scores of Japanese Orthopedics Association （ JOA） ,neck disability index （ NDI） and visual analogue scale （ VAS） before and after the surgical procedures . The range of motion（ROM）of the surgical segment and the C2～7 cervical spine and Disc height index（DHI）were measured.Results All of the patients were followed up from 12 to 24 months with a mean time of 16.5 months.The clinical and radiological outcomes were all satisfied with improved JOA scores and scores of NDI and VAS when compared to pre-operation （ P〈0.05 ） .The postoperative DHI was significantly increased and maintained during the period of follow-up（ P〈0.05 ） .Conclusion The DCI could recover DHI ,main-tain the dynamic stability and the ROM of the surgical segment .The method is an alternative choice of the anterior non-fusion tech-niques.The method can also combine with artificial disc replacement （TDR）and anterior cervical discectomy and fusion （ACDF）.This technique has broad indications and simple procedure as well as reliable curative effect .

关 键 词：颈椎病 颈椎动态稳定器 前路手术 非融合技术 

分 类 号：R687.3[医药卫生—骨科学]