Bryan人工颈椎间盘置换术治疗颈椎病早中期疗效观察Intermediate observation of motion range follow-up after treatment of degenerative disc disease with the Bryan cervical disc prosthesis
杨述华;李进;刘国辉;许伟华;杨操;叶树楠;胡勇;
摘要(Abstract):
[目的]探讨Bryan人工颈椎间盘置换术缓解颈椎病神经症状和体征,提高患者的生活质量,并保持颈椎稳定和节段活动。[方法]对19例23个椎间盘的人工颈椎间盘置换术进行了随访。随诊时间:8~76个月,平均29个月。其中脊髓型颈椎病15例,其他4例。男12例,女7例;年龄35~52岁,平均40.5岁。单节段置换16例,双节段2例,3节段1例。[结果]术中或术后没有神经和血管损伤的并发症。JOA评分从平均8.6分增加到15.8分。没有假体下沉和明显偏移。置换节段稳定并部分恢复了颈椎正常的活动范围,前屈和后伸活动范围是4.68°(3.6°~6.1°);左右侧屈的活动范围是3.51°(2.5°~4.6°)、3.42°(2.6°~4.3°)。CT和MRI随访表明2/23节段的假体偏移<1.5 mm。颈椎的生理弧度没有明显的丢失。置换节段假体周围没有骨化。[结论]19例人工颈椎间盘置换术取得了满意的近期疗效。与颈椎前路椎间盘摘除植骨融合术最大的不同点是患者恢复快,没有颈椎活动受限的缺陷。但至少需要5年的长期随访来评价假体的功能和对邻近节段的影响。
关键词(KeyWords): 人工颈椎假体;人工颈椎间盘;颈椎间盘突出症;退行性颈椎间盘疾病
基金项目(Foundation):
作者(Author): 杨述华;李进;刘国辉;许伟华;杨操;叶树楠;胡勇;
Email:
DOI:
参考文献(References):
- [1]Wiffield CC,Skrzypiec D,Jackowski A,et al.Internal stress distribu-tion in cervical intervertebral discs:the influence of an artificial cervi-cal joint and simulated anterior interbody fusion[J].J Spinal DisordTech,2003,5:441-449.
- [2]Mayer HM,Wiechert K,Korge A,et al.Minimally invasive total discreplacement:surgical technique and preliminary clinical results[J].Eur Spine J,2002,11:124-130.
- [3]Goffin.Presented at the annual meeting of the spinal arthroplasty socie-ty[M].Montpellier,France,2002.
- [4]DiAngelo DJ,Roberston JT,Metcalf NH,et al.Biomechanical testing ofan artificial cervical joint and an anterior cervical plate[J].J SpinalDisord Tech,2003,4:314-323.
- [5]Goffin J,Calenbergh FV,Loon JV,et al.Intermediate follow-up aftertreatment of degenerative disc disease with the Bryan cervical discprosthesis:single-level and bi-level[J].Eur Spine J,2003,4:2673-2678.
- [6]Sekhon LH.Cervical arthroplasty in the management of spondylotic my-elopathy.J Spinal Disord Tech.2003 Aug;16:307-313.
- [7]Bryan VE.Cervical motion segment replacement replacement.Eur SpineJ.2002 Oct;11:92-97.
- [8]Wigfield CC,Gll SS,Nelson RJ,et al.The newFrenchay artificial cer-vical joint:results from a two-year pilot study,Spine.2002 Nov 15;27:2446-2452.
- [9]Pointillart V.Cervical disc prosthesis in humans:Frist failures.Spine2001;26:90-92.