詹世强;昌耘冰;顾宏林;曾时兴;柯雨洪;刘斌;王义生;尹东;

• 1:广东省人民医院(广东省医学科学院)

摘要(Abstract)：

[目的]总结分析Discover人工颈椎间盘置换治疗颈椎间盘退变性疾病的早中期疗效及并发症。[方法]回顾性分析2011年3月²014年11月使用Discover人工颈椎间盘置换术治疗颈椎间盘退变性变患者共92例,男56例,女36例;年龄272014年11月使用Discover人工颈椎间盘置换术治疗颈椎间盘退变性变患者共92例,男56例,女36例;年龄27⁶8岁,平均49.4岁。采用疼痛视觉模拟评分法(visual analogue scale,VAS)评定疼痛症状改善情况,采用日本骨科协会(Japanese Orthopedics Association,JOA)脊髓功能评分(17分法)及颈椎功能障碍指数(neck disability index,NDI)评价术后功能改善情况。行颈椎正侧及动力位X线片检查测定并比较手术前后手术节段椎间盘平均高度(disc height,DH)、手术节段脊柱功能单位(functional spinal unit,FSU)Cobb角及C_(268岁,平均49.4岁。采用疼痛视觉模拟评分法(visual analogue scale,VAS)评定疼痛症状改善情况,采用日本骨科协会(Japanese Orthopedics Association,JOA)脊髓功能评分(17分法)及颈椎功能障碍指数(neck disability index,NDI)评价术后功能改善情况。行颈椎正侧及动力位X线片检查测定并比较手术前后手术节段椎间盘平均高度(disc height,DH)、手术节段脊柱功能单位(functional spinal unit,FSU)Cobb角及C_(2⁷)Cobb角的变化情况。总结术中及术后并发症,分析其原因。[结果]92例患者中89例获得完整随访,随访时间(37)Cobb角的变化情况。总结术中及术后并发症,分析其原因。[结果]92例患者中89例获得完整随访,随访时间(3⁴7)个月,平均26.5个月。末次随访时患者的VAS、JOA及NDI评分均较术前明显改善(P<0.05)。术前手术节段DH为(4.41±0.76)cm,术后为(6.29±0.38)cm,差异有统计学意义(P<0.05);术前FSU Cobb角为(11.00±4.36)°,术后为(11.67±5.17)°,差异无统计学意义(P=0.854);术前C247)个月,平均26.5个月。末次随访时患者的VAS、JOA及NDI评分均较术前明显改善(P<0.05)。术前手术节段DH为(4.41±0.76)cm,术后为(6.29±0.38)cm,差异有统计学意义(P<0.05);术前FSU Cobb角为(11.00±4.36)°,术后为(11.67±5.17)°,差异无统计学意义(P=0.854);术前C2⁷Cobb角为(42.89±14.81)°,术后为(46.56±11.10)°,差异无统计学意义(P=0.418)。9例(10.1%)患者出现术后并发症,其中2例术后出现假体轻度前移,5例出现异位骨化(heterotopic ossification,HO),2例出现假体轻度前移位合并HO,但均无相应临床症状,未行处理。[结论]Discover人工颈椎间盘置换治疗颈椎退变性疾病的早中期有效性及安全性肯定,但存在一定并发症风险,远期效果仍待观察。

关键词(KeyWords)： 颈椎间盘退变性疾病;人工颈椎间盘置换术;并发症

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 詹世强;昌耘冰;顾宏林;曾时兴;柯雨洪;刘斌;王义生;尹东;

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