中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (39): 7221-7226.doi: 10.3969/j.issn.2095-4344.2012.39.001

• 人工假体 artificial prosthesis •    下一篇

椎间盘置换中体位对假体置入后活动度的影响

邓宇骁1，洪 瑛2，刘 浩1，胡 韬1，丁 琛1，龚 全1，李 涛1，宋跃明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:2012-07-16 修回日期:2012-08-14 出版日期:2012-09-23 发布日期:2012-09-23
  • 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:邓宇骁☆，男，1987年生，四川省汶川县人，汉族，四川大学在读博士，主要从事脊柱外科方面的研究。 nanshine710@gmail.com

Effects of intra-operative cervical posture in cervical disc replacement on post-operative cervical range of motion

Deng Yu-xiao1, Hong Ying2, Liu Hao1, Hu Tao1, Ding Chen1, Gong Quan1, Li Tao1, Song Yue-ming1   

  1. 1Department of Orthopedics, 2Operation Room, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2012-07-16 Revised:2012-08-14 Online:2012-09-23 Published:2012-09-23
  • Contact: Liu Hao, Professor, Doctoral supervisor, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China liuhao6304@163.com
  • About author:Deng Yu-xiao☆, Studying for doctorate, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China nanshine710@gmail.com

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583

被引次数

6

摘要：

背景：颈椎间盘置换由于其能保留目标节段的运动功能同时延缓临近节段的退变，目前的应用十分广泛。但是在颈椎间盘置换中，患者的体位放置及其对置换后假体活动度的影响尚不明确。
目的：探讨颈椎间盘置换中体位摆放和置换后植入假体活动度的相关性。
方法：对四川大学华西医院2008-01/2010-07接受单节段PRESTIGE LP颈椎间盘置换共49例患者的影像学资料进行回顾性研究。收集患者置换中C臂透视及置换前后的颈椎矢状中立位及功能位(过伸、过屈位)X射线片，测量目标椎间盘的Cobb角，对其置换前中的差异、置换前后的改善等数据进行线性相关检验及线性回归分析。
结果与结论：与置换前相比，目标椎间盘在置换中的前凸角度变化差异无显著性意义(P > 0.05)，置换后中立位、过屈位及过伸位的角度均有不同程度改善(P < 0.01)，置换后整体活动范围部分变化差异无显著性意义，其中前屈动度增加(P < 0.01)，后伸动度变化差异无显著性意义(P > 0.05)。目标椎间盘置换后假体的角度及活动范围与置换前中角度差异存在线性相关(P < 0.01)。证实颈椎间盘置换中颈椎位置的合理放置对植入椎间盘置换后的活动范围，尤其是前屈活动范围的改善具有重要影响。

关键词: 颈椎间盘置换, 体位, 人工椎间盘, 活动度, 骨科植入物, 人工假体, 骨科内固定物, 组织工程

Abstract:

BACKGROUND: Cervical disc replacement is widely used for cervical spondylosis as it can maintain cervical motion of the target segments and reduce the degeneration of adjacent segments. But few studies have focused on the influence of intra-operative cervical posture in the cervical disc replacement to the post-operative cervical motion.
OBJECTIVE: To check the correlation between intra-operative cervical posture and post-operative cervical motion in cervical disc replacement.
METHODS: Forty-nine patients that underwent single segmental PRESTIGE LP cervical disc replacement surgery from January 2008 to July 2010 in West China Hospital, Sichuan University were enrolled in this retrospective study. X-ray film of the C-arm fluoroscopy as well as the cervical sagittal neutral position and dynamic position (hyperextension, flexion) before and after replacement were collected, and the target intervertebral disc Cobb angle was measured. Linear correlation and regression were preformed to analyze the relation between angle difference before and during replacement and motion improvement before and after replacement.
RESULTS AND CONCLUSION: There was no significant difference of the lordotic angle of the aimed disc during cervical disc replacement before and after replacement (P > 0.05); after replacement, the angle of the artificial disc was improved in neutral position, hyperextension and flexion (P < 0.01), and there was no significant difference of the overall range of motion after replacement; the overall range of motion was increased in flexion direction (P < 0.01), and there was no significant difference of the overall range of motion in extension direction (P > 0.05). There was a linear correlation between the angle and range of motion and angle difference before and during replacement (P < 0.01). A moderate lordotic intra-operative cervical posture is vital to range of motion artificial disc after cervical disc replacement, especially in the flexion direction.

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