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The clinical study of cervical arthroplasty in management of cervical spondylosis
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF SURGERY
- Issue:
- 20
- DOI:
- 10.3760/j.issn.0529-5815.2006.20.005
- Key Word:
- 颈椎病;椎间盘;关节成形术,置换;融合
Abstract： 目的 探讨Bryan颈人工椎间盘假体置换术治疗颈椎病的临床疗效,同时与颈前路减压植骨融合术相比较,观察两种术式的近期临床疗效.方法 脊髓型和神经根型颈椎病患者共48例,21例(22个节段)行颈前路颈人工椎间盘假体置换术(置换组),27例(32个节段)采用颈前路减压植骨融合术(融合组).两组患者分别在术前,术后,术后3、6、12、18个月观察以下指标:JOA评分;摄颈椎前屈后伸位、左右侧屈位X线片,观察置换组的假体稳定性和植入节段及上下临近节段的活动度,观察融合组融合节段的上下临近节段的关节活动度;MRI或CT扫描检查颈人工椎间盘假体位置及有无异位骨化现象.结果 两组术后临床症状缓解,脊髓功能改善,均无并发症.两组JOA评分比较:术后各时间段较术前明显提高(P＜0.01),两组术后各时间段之间的评分比较无显著差异.术后各时间段随访摄X线片显示:置换组置换节段较术前保留了部分关节活动度,上下临近关节活动度未显著增加,未发现假体偏移或下沉;而融合组临近节段活动度显著高于置换组(P＜0.01).术后CT或MRI扫描显示:置换组假体位于临近上、下终板骨的中央,未见假体周围异位骨化现象;融合组出现1例下临近节段退变压迫脊髓.结论 与颈前路减压植骨融合术比较,颈人工椎间盘置换术既能良好地达到前路减压目的,又能保持颈椎病变节段的部分活动度和稳定性,且未显著增加上下临近节段活动度,取得了较好的近期临床疗效.
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