颈椎人工椎间盘置换术与颈前路减压融合内固定术手术疗效比较  

Comparing the effects of Bryan cervical Disc arthroplasty with anterior cervical decompression and fusion

作　　者：张涛[1] 王弘[1] 徐宏光[1] 李从明[1] 

机构地区：[1]皖南医学院第一附属医院弋矶山医院脊柱外科,安徽芜湖241001

出　　处：《皖南医学院学报》2016年第6期527-530,共4页Journal of Wannan Medical College

基　　金：国家自然科学基金项目(81272048);安徽高校省级自然科学研究项目(KJ2013A253)

摘　　要：目的：比较颈椎人工椎间盘置换术（ cervical disc arthroplasty ，CDA）与颈前路减压融合内固定术（ anterior cervical de-compression and fusion ，ACDF）的手术疗效。方法：回顾分析2012年8月～2015年1月收治的退变性颈椎病50例，随机给予CDA（n＝23），或者ACDF（n＝27）治疗，术后12个月门诊随访。结果：两组术前性别、年龄、手术节段活动度（range of motion， ROM）、VAS（ visual analogue scale ）及JOA（ Japanese orthopaedic association ）无统计学差异，CDA组比ACDF组手术时间短，出血量少，具有明显统计学差异（ P＜0．01），两组住院时间无明显统计学差异。术后12个月，两组手术节段ROM差异具有统计学意义（ P＜0．01），CDA组ROM较术前得以维持，ACDF组降低。两组JOA及VAS无统计学差异。结论：CDA较ACDF能维持手术节段的活动度，CDA有望取代ACDF。Objective：To compare curative effects of Bryan cervical disc arthroplasty （ CDA） with those of anterior cervical decompression and fusion （ AC-DF）.Methods：A total of 50 patients with cervical spondylotic myelopathy treated in our hospital between August 2012 and January 2015 were randomly as-signed to two groups.One group were treated with CDA （n=23） and another with ACDF（n=27）.Two groups of patients were postoperatively followed on outpatient basis for 12 months.Results：The two groups were not significantly different regarding the gender,ages,range of cervical motion（ROM） and sco-ring on visual analogue scale（VAS） and Japanese Orthopedic Association（JOA）.CDA group had shorter operative time and intraoperative blood loss than ACDF group,the difference was significant（ P〈0.01） .The length of hospital stay remained similar for the two groups ,yet the two groups were different con-cerning the ROM 12 month after operation（P〈0.01）.Postoperative ROM was maintained in patients in CDA group,whereas was decreased in ACDF group. There was no statistical difference regarding the JOA and VAS scores between two groups .Conclusion：CDA can lead to better maintenance of ROM than ACDF after operation,and the former may be wider clinical recommendation .

关 键 词：颈前路减压融合 BRYAN颈椎人工椎间盘 颈椎病 

分 类 号：R687.3[医药卫生—骨科学]