中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (17): 3047-3052.doi: 10.3969/j.issn.1673-8225.2011.17.004

• 人工假体 artificial prosthesis • 上一篇    下一篇

Bryan人工颈椎间盘置换治疗颈椎病的中期临床随访

丁  琛1，刘  浩1，胡  韬1，石  锐1，李  涛1，洪  瑛2，宋跃明1，刘立岷1，曾建成1，孔清泉1   

  1. 四川大学华西医院，1骨科，2手术室，四川省成都市 610041
  • 收稿日期:2010-12-28 修回日期:2011-02-12 出版日期:2011-04-23 发布日期:2011-04-23
  • 通讯作者: 刘浩，教授，博士生导师，四川大学华西医院骨科，四川省成都市 610041 Liuhao6304@163.com
  • 作者简介:丁琛☆，男，1984年生，四川省内江县人，汉族，四川大学在读博士，医师，主要从事脊柱外科的研究。 dclxm_84213@163.com

Clinical outcome of Bryan artificial cervical disc replacement for the treatment of cervical spondylosis: A midterm follow-up 

Ding Chen1, Liu Hao1, Hu Tao1, Shi Rui1, Li Tao1, Hong Ying2, Song Yue-ming1, Liu Li-min1, Zeng Jian-cheng1, Kong Qing-quan1   

  1. 1Department of Orthopedics, 2Operation Room, West China Hospital of Sichuan University, Chengdu  610041, Sichuan Province, China
  • Received:2010-12-28 Revised:2011-02-12 Online:2011-04-23 Published:2011-04-23
  • Contact: Liu Hao, Professor, Doctoral supervisor, Department of Orthopedics, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China liuhao6304@163.com
  • About author:Ding Chen☆, Studying for doctorate, Physician, Department of Orthopedics, West China Hospital of Sichuan University, Chengdu 61004, Sichuan Province, China dclxm_84213@163.com

PDF

500

被引次数

26

摘要：

背景：Bryan人工颈椎间盘置换的短期疗效优良已被大多数学者公认，但有关其中长期临床效果及并发症的资料较少。
目的：总结Bryan人工颈椎间盘置换治疗颈椎病的中期临床效果。
方法：选择2004-11/2007-12在四川大学华西医院骨科接受Bryan人工颈椎间盘置换的颈椎间盘突出症患者34例，其中单节段置换30例，双节段置换4例。于置换前、置换后7 d、3，6，12，24，36，48个月行SF-36生活质量量表评分、JOA评分、颈部及上肢疼痛目测类比评分；以颈椎正侧位及功能位X射线片测量手术节段、邻近节段及C2~7屈伸活动度的变化，手术节段和邻近节段椎间高度变化及手术节段的轴向平移情况。
结果与结论：所有患者置换后神经症状均明显好转，各随访点SF-36生活质量量表躯体评分和心理评分、JOA评分、颈部和上肢疼痛目测类比评分较置换前明显改善(P < 0.05)，3个月之后各随访时点两两比较差异无显著性意义(P  > 0.05)。置入的Bryan假体历次随访均保留了>2°的活动度，未发现手术节段异位骨化与自发性融合，随访48个月时手术节段及C2~7屈伸活动度较置换前略有增加，但差异无显著性意义(P > 0.05)；上下邻近节段屈伸活动度维持了置换前水平；手术节段的椎间高度由置换前的(6.04±1.02) mm增加到(8.44±0.43) mm(P  < 0.05)；上下邻近节段椎间高度及手术节段的轴向平移均维持了置换前水平。说明Bryan人工颈椎间盘治疗颈椎间盘退变性疾病的中期临床效果良好，较好的保留了手术节段、邻近节段及整个颈椎的运动学特性，且近中期并发症很少。

关键词: 颈椎病, 颈椎间盘突出症, 人工颈椎间盘置换, 临床效果, 活动度, 并发症

Abstract:

BACKGROUND: Although the short-term clinical efficacy of Bryan artificial cervical disc replacement is generally acknowledged by most spinal surgeons, the midterm and long term clinical results and complications are still unclear.
OBJECTIVE: To summarize midterm term clinical results of Bryan artificial cervical disc replacement for the treatment of cervical spondylosis.
METHOD: From November 2004 to December 2007, 34 patients had Bryan cervical disc replacement in Department of Orthopedics, West China Hospital were selected, including 30 cases with single replacement and 4 cases with bi-level replacement. Clinical result was evaluated by SF-36 score, JOA score, and neck/arm pain VAS scores. And the data was collected before surgery and at 7 days, 3, 6, 12, 24, 36 and 48 months after surgery. Neutral lateral and dynamic cervical radiographs were made to measure the flexion-extension range of motion (ROM) of operative segment, adjacent segments and C2-7 segment, the intervertebral height of operative and adjacent segments, and the translation of operative level. The intraoperative and postoperative complications were recorded and analyzed.
RESULTS AND CONCLUSION: The neurological symptoms of each patient were alleviated notably. The postoperative SF-36 physical component score and SF-36 mental component score, JOA score, NDI score and neck/arm pain VAS scores were significantly improved compared with those of the preoperative (P  < 0.05), but no statistical significance were noted between each time point after 3-month follow-up (P  > 0.05). Each implanted prosthesis preserved the ROM>2° at each follow-up time point, and no heterotopic ossification or spontaneous fusion was found at the operative segment. At 48-month follow-up, flexion-extension ROM of operative segment and C2-7 segment slightly increased but showed no statistical significance compared with the preoperative counterparts (P > 0.05); ROM of upper and lower adjacent segments also showed no statistical significance compared with the preoperative data (P > 0.05). Intervertebral height of operative segment was (6.04±1.02) mm before the operation and significantly increased to (8.44±0.43) mm at 48-month follow-up (P  < 0.05). Intervertebral height of adjacent segments, and the translation of operative level were not significantly changed (P  > 0.05). The clinical result of Bryan artificial cervical disc replacement is good and kinematic characteristics of operative segment, adjacent segments and C2-7 segment can be maintained in midterm follow-up. The operation is safe and there are few early midterm complications.

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