Discover颈椎间盘置换对颈椎曲度和置换节段的影响  

Effect of Discover Cervical Artificial Disc Replacement on Cervical Curvature and Replacement Segment

作　　者：顾叶[1] 彭育沁[1] 薛峰[1] 盛晓文[1] 徐怡良[1] 陆建明[1] 

机构地区：[1]苏州大学附属常熟市第一人民医院骨科,江苏常熟215500

出　　处：《实用骨科杂志》2016年第1期1-6,共6页Journal of Practical Orthopaedics

摘　　要：目的观察单节段Discover人工颈椎间盘置换术及颈椎前路减压融合术后颈椎整体曲度和置换节段活动度的变化情况,分析其临床效果。方法回顾性分析2008年3月至2013年3月治疗的48例颈椎病及颈椎间盘突出症患者,其中18例行Discover人工颈椎间盘置换术（置换组）,男8例,女10例,年龄31-58岁,平均44.2岁;30例行颈椎前路减压融合术（融合组）,男13例,女17例,年龄35-68岁,平均49.8岁。测量手术前后和末次随访时置换节段活动度（range of motion,ROM）,置换节段脊柱功能单位（functional spinal unit,FSU）Cobb角和颈椎整体曲度（C2-7Cobb角）。结果两组患者均获得12个月以上随访,末次随访置换节段屈伸活动度置换组较术前稍增加,左右侧屈活动度无明显变化,而融合组屈伸及左右侧屈活动度较术前明显减小,差异有统计学意义（P〈0.05）;两组间末次随访相比较,融合组屈伸及左右侧屈活动度明显减小,差异有统计学意义（P〈0.05）。末次随访FSU置换组较术前明显增加,差异有统计学意义（P〈0.05）,而融合组无明显变化;两组间末次随访相比较,置换组明显增加,差异有统计学意义（P〈0.05）。末次随访颈椎曲度置换组较术前稍增加,而融合组较术前明显减小,差异有统计学意义（P〈0.05）;两组间末次随访相比较,融合组明显减小,差异有统计学意义（P〈0.05）。结论单节段Discover人工颈椎间盘置换术后对颈椎整体曲度及置换节段活动度的影响小,与传统前路减压融合术相比,可以较好发挥其对颈椎的保护作用。Objective To observe the changs of cervical curvature and ROM after Discover cervical disc arthroplasty and anterior cervical decompression and fusion,and to analyse its clinical effect. Methods We retrospectively analyzed of 48 cases of cervical spondylosis and cervical disc herniation from 2008 March to 2013 March. 18 cases underwent Discover cervical artificial disc replacement（ male 8,female 10,age 31 ~ 58 years old,average 44. 2 years old）. 30 cases of anterior cervical decompression and fusion（ male 13,female 17,age 35 ~ 68 years old,average 49. 8 years old）. The range of motion（ ROM）,functional spinal unit Cobb angle（ FSU） and cervical curvature（ C2 ~ 7Cobb angle） were measured before and after operation and at the final follow-up. Results The two groups received at least 12 months follow-up. At the last follow-up,the flexion and extension of replacement group was slightly increased,the right and left lateral flexion had no obvious changes,while the motion were significantly decreased in the fusion group（ P〈0.05）. Between the two groups,the motion of fusion group were significantly reduced at the last follow-up（ P〈0.05）. The FSU of replacement group was increased significantly compared with the preoperative（ P〈0.05）,while it had no obvious changes in the fusion group. Between the two groups,the FSU of replacement group was significantly increased at the last follow-up（ P〈0.05）. The cervical curvature of replacement group was slightly increased,while the one of fusion group was decreased significantly（ P〈0.05）. Between the two groups,the cervical curvature of fusion group was significantly decreased（ P〈0.05）. Conclusion Discover artificial cervical disc replacement has little effect on cervical curvature and ROM,and it has better protection on cervical vertebra compared with the traditional anterior cervical decompression and fusion.

关 键 词：人工颈椎间盘 脊柱功能单位 颈椎曲度 颈椎活动度 

分 类 号：R681.55[医药卫生—骨科学]