人工腰椎间盘(Charité Ⅲ)置换治疗腰椎间盘病长期疗效  

Charité artificial total disc replacement:clinical and radiographical results after an average follow-up of 11.6 years

作　　者：卓祥龙 胡建中[2] 王文军[3] 李康华[2] 王锡阳[2] 燕怡果 吴天定[2] 

机构地区：[1]柳州市工人医院脊柱外科,广西柳州市柳石路1号545001 [2]中南大学湘雅医院脊柱外科,长沙市湘雅路87号410008 [3]南华大学附属第一医院脊柱外科,湖南省衡阳市船山路69号421001

出　　处：《中国矫形外科杂志》2017年第1期5-9,共5页Orthopedic Journal of China

摘　　要：[目的]评价人工腰椎间盘置换治疗退行性腰椎间盘病的长期疗效,探讨其临床价值。[方法]2000年1月~2006年1月,对17例患者使用CharitéⅢ进行人工腰椎间盘置换,17例均得到随访,随访时间平均11.6年(8.5~14.2年)。术前、术后采用VAS、ODI进行评分,根据X-ray评价椎间隙高度的变化及手术节段活动度,CT、MRI评价临近节段小关节及椎间盘退变情况,评价临床结果。[结果]17例患者19个椎间盘被纳入研究,患者满意度达88.2%,术后随访VAS、ODI评分较术前均得到明显的改善,最终临床结果优良率88.2%。ROM和椎间隙高度较术前明显改善(P<0.05)。临近节段椎间盘和椎旁肌退变加重(P<0.05),而小关节退变则没有明显改变(P>0.05)。术后切口裂开3例;自发性融合1例,亦出现椎间盘退变、小关节退变;异位骨化1例,余无其他并发症。[结论]人工腰椎间盘置换治疗腰椎间盘病长期随访结果比较满意,是理想的手术方法。由于本组病例较少,还需要增加病例数进行进一步研究。[Objective] To investigate the long-term effect and clinical value of artificial intervertebral disc replacement in the treatment of degenerative lumbar disc disease. [Methods] A total of 17 patients underwent artificial intervertebral disc replacement using Charit6 III from January 2000 to January 2006 and were followed up for a mean of 11.6 years （range 8.5- 14.2 years） . The Visual Analogue Scale （VAS） and Oswestry disability index （ODI） scores were determined before and after surgery. X-ray was used to evaluate the change of disc height and the range of motion of the segment involved in surgery, and CT and MRI were used to evaluate facet joint degeneration and intervertebral disc degeneration in the neighboring seg- ments. The clinical outcome was evaluated. [ Results ] A total of 19 times of artificial intervertebral disc replacement in 17 pa- tients were enrolled. The patients＇ degree of satisfaction reached to 88.2%. The VAS and ODI scores were significantly im- proved during postoperative follow-up, and 88.2% excellent and good outcomes were achieved. The range of motion and disc height were significantly improved after surgery （P 〈0.05） . The intervertebral disc degeneration in the neighboring segments and paravertebral muscle degeneration were aggravated （P 〈0.05） , while showing no significant change in facet joint degen- eration （P 〉0.05） . Postoperative comlications were found in 7 cases, 3 for wound disruption, one each for spontaneous fusion, intervertebral disc degeneration, facet joint degeneration as well as ectopic ossification, respectively. There were no other com- plications. [Conclusions] Artificial intervertebral disc replacement has an ideal long-term clinical effect and can be used as a surgical method for the treatment of degenerative lumbar disc disease. Since the number of patients enrolled in this study is relatively small, further studies should be conducted with more cases.

关 键 词：腰椎间盘置换术 退变性椎间盘病 长期随访 

分 类 号：R687.3[医药卫生—骨科学]