单节段Prestige LP人工颈椎椎间盘置换术在骨量减少颈椎病患者中的应用  

Application of single-segment Prestige LP artificial cervical disc replacement in cervical spondylosis patients with osteopenia

作　　者：陈华[1] 伍援朝[2] 刘浩[1] 王晓斐 海米提·阿布都艾尼 龚全[1] 邓宇骁[1] Chen Hua;Wu Yuanchao;Liu Hao;Wang Xiaofei;Haimiti·Abudouaini;Gong Quan;Deng Yuxiao(Department of Orthopaedics,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China;Department of Bone Mineral Density,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)

机构地区：[1]四川大学华西医院骨科,成都610041 [2]四川大学华西医院骨密度室,成都610041

出　　处：《脊柱外科杂志》2021年第3期145-150,共6页Journal of Spinal Surgery

基　　金：四川省科技计划重点研发项目(2019YFS0135)。

摘　　要：目的探讨骨量减少的颈椎病患者行单节段Prestige LP人工颈椎椎间盘置换术的安全性和有效性。方法回顾性分析2012年2月—2017年6月本院采用Prestige LP人工颈椎椎间盘单节段置换术治疗的22例骨量减少的颈椎病患者临床资料。在术前,术后3 d、3个月、6个月、12个月及末次随访时采用日本骨科学会(JOA)评分评价患者神经功能,采用疼痛视觉模拟量表(VAS)评分及颈椎功能障碍指数(NDI)评估患者颈肩部疼痛及颈椎功能情况。在术前,术后3 d、3个月、6个月、12个月及末次随访时测量患者颈椎整体曲度、颈椎整体活动度(C_(2~7) ROM)、置换节段椎间角度、置换节段ROM(rROM)、置换节段椎间隙高度、置换节段脊柱功能单位(FSU)高度、邻近节段ROM(aROM)及邻近节段椎间隙高度等。观察并记录假体下沉、移位情况。结果所有手术顺利完成。所有患者随访26~78个月,平均38.2个月。末次随访时所有患者JOA评分、VAS评分及NDI均较术前显著改善,差异有统计学意义(P<0.05)。末次随访时置换节段椎间隙高度及FSU高度与术前相比显著增加,差异均有统计学意义(P<0.05)。末次随访时颈椎整体曲度、C2~7 ROM、置换节段椎间角度、rROM、aROM及邻近节段椎间隙高度等与术前相比,差异均无统计学意义(P>0.05)。至末次随访时,发生假体下沉3例,移位2例。结论采用单节段Prestige LP人工颈椎椎间盘置换术治疗骨量减少的颈椎病患者安全有效,可维持满意的椎间隙高度和ROM,但需警惕假体下沉和移位等并发症。Objective To investigate the safety and efficacy of single-segment Prestige LP artificial cervical disc replacement in cervical spondylosis patients with osteopenia.Methods The clinical data of 22 cervical spondylosis patients with osteopenia treated by single-segment Prestige LP artificial cervical disc replacement from February 2012 to June 2017 were retrospectively analyzed.Japanese Orthopaedic Association(JOA)score was used to evaluate the neurological function of the patients.The visual analogue scale(VAS)score and neck disability index(NDI)were used to evaluate the neck and shoulder pain and function at pre-operation,postoperative 3 d,3 months,6 months,12 months and final follow-up.The overall cervical curvature,overall range of motion(C_(2-7) ROM),intervertebral angle of replacement segment,ROM of replacement segment(rROM),intervertebral space height of replacement segment,height of function of spinal unit(FSU)of replacement segment,ROM of adjacent segment(aROM)and intervertebral space height of adjacent segment were measured at pre-operation,postoperative 3 d,3 months,6 months,12 months and final follow-up.The subsidence and displacement of the prosthesis were observed and recorded.Results All the operations were successfully completed.All the patients were followed up for 26-78 months,with an average of 38.2 months.The JOA score,VAS score and NDI of all the patients were significantly improved at the final follow-up,and the differences were statistically significant(P<0.05).At the final follow-up,the height of intervertebral space and FSU of the replacement segment were significantly increased compared with those at pre-operation,all with a statistical significance(P<0.05).At the final follow-up,there were no significant differences in the overall cervical curvature,C2-7 ROM,intervertebral angle of replacement segment,rROM,aROM and the intervertebral space height of adjacent segment compared with those at pre-operation(P>0.05).At the final follow-up,there were 3 cases of prosthesis subsidence and 2 of pr

关 键 词：颈椎 颈椎病 假体和植入物 

分 类 号：R681.531[医药卫生—骨科学]