C5/6 Prestige LP人工颈椎间盘置换术后不同屈伸运动特性的临床疗效观察  

Clinical observation of different flexion and extension characteristics after C5/6 Prestige LP intervertebral disc replacement

作　　者：江洋 刘浩[1] 戎鑫[1] 丁琛[1] 孟阳[1] 王贝宇[1] 王翰 JIANG Yang;LIU Hao;RONG Xin;DING Chen;MENG Yang;WANG Bei-yu;WANG Han(Department of Orthopedics,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Spinal Orthopedics,The Second Affiliated Hospital of Chengdu Medical College,416 Nuclear Industry Hospital,Chengdu 610051,China)

机构地区：[1]四川大学华西医院骨科,四川成都610041 [2]成都医学院第二附属医院,核工业四一六医院脊柱骨科,四川成都610051

出　　处：《实用医院临床杂志》2021年第2期8-11,共4页Practical Journal of Clinical Medicine

基　　金：四川省科技厅重点研发项目(编号:2019YFQ0002)。

摘　　要：目的探讨人工颈椎间盘置换术后手术节段屈曲、后伸活动差异对临床疗效的影响。方法四川大学华西医院脊柱外科行C5/6单节段Prestige LP人工颈椎间盘置换的110例患者,依据术后手术节段矢状面屈曲、后伸活动度大小的不同,分为屈>伸、屈=伸、屈<伸三组。采用日本骨科协会(JOA)评分、颈椎功能障碍指数(NDI)、疼痛视觉模拟评分(VAS)评估患者的临床疗效;影像学评价指标包括矢状面屈伸活动特性分组评价、颈椎整体曲度、颈椎整体活动度、置换节段活动度及异位骨化率。结果随访时间24~109月(31.2±17.9)月。末次随访三组VAS、JOA、NDI评分及颈椎整体曲度和活动度、置换节段活动度比较差异均无统计学意义(P>0.05),HO发生率屈>伸组为10.21%,屈=伸组为7.41%,屈<伸组为35.29%,屈<伸组HO发生率显著高于另外两组(P<0.05)。结论C5/6单节段Prestige-LP间盘置换术后,不同矢状面屈伸运动特性不影响患者术后临床疗效、置换节段活动度、颈椎整体曲度及活动度,术后手术节段后伸活动度大于屈曲活动度可能是异位骨化率增高的影响因素。Objective To investigate the effect of the differences in flexion and extension of surgical segments on the clinical outcomes after cervical disc replacement.Methods A total of 110 patients with Prestige LP cervical disc replacement at C5/6 single segment in West China Hospital were involved in this study.The patients were divided into flexion>extension,flexion=extension and flexion<extension groups according to the difference in the degree of flexion and extension of the sagittal plane after operation.The clinical outcomes were evaluated by the Japanese Orthopaedic Association(JOA)score,neck disability index(NDI)scale and visual analogue scale(VAS).Imaging evaluation indexes included group evaluation of sagittal flexion-extension activity characteristics,overall curvature of the cervical spine and replacement segment mobility as well as incidence of heterotopic ossification(HO).Results The follow-up duration ranged from 24 to 109 months(31.2±17.9 months).At the final follow-up,no statistical differences were observed in scores of VAS,JOA and NDI scores,overall curvature and mobility of the cervical spine,and comparison of mobility of the replacement segment among three groups(P>0.05).The incidence of HO was 10.21%,7.41%and 35.29%in the three groups,respectively.The incidence of HO was significantly higher in the flexion<extension group when compared to other two groups(P<0.05).Conclusion Different flexion-extension characteristics have no impact on postoperative clinical outcomes,mobility and curvature of replacement segment of cervical spine.The greater postoperative mobility of extension than flexion at the replacement segment may be the risk factor for heterotopic ossification.

关 键 词：人工椎间盘置换 屈伸特性 疗效观察 异位骨化 

分 类 号：R687.4[医药卫生—骨科学]