Objective To evaluate the short-term radiological and functional outcome of artificial disc replacement for Cervical spondylotic myelopathy. Methods Twelve patients with cervical spondylotic myelopathy underwent DISCOVER artificial disc replacement. There were 8 cases of cervical spondylotic myelopathy and 4 of nerve root cervical syndrome. The ROM of the cervical spine、ROM of treated segment and ROM of adjacent segment were reviewed respectively at preoperative and 1month,6 months and the last follow up postoperative,and the NDI scores、VAS for neck and arm pain were also reviewed respectively preoperative and the last follow-up. Results At an average of 14 months (range 9 18 months)follow-up,the neurologic symptom and sign in all cases had significant improvement. The NDI was significantly improved from(54.2±13.2)％ to(24.0±6.8)％(P＜0.01),the VAS for neck and ann pain were all significantly improved from (5.6±1.8)and (4.5±2.1)to (1.8±0.9)and (1.0±0.5)respectively (P＜0.01). 8 patients got excellent clinical results,3 patients got good results and another 1 patients got fair results according to Odom's criteria,the excellent and good rate was 91.7％. The ROM of the cervical spine、ROM of treated segment and ROM of adjacent segment were significantly decreased at 1 month follow up(P＜0.01 ),but improved to preoperative level at 6 months and the last follow up (P＞0.01). There was no neurological complications during operation,and no ossification in the replaced level and no prosthesis displacement and loosening. Conclusion Our findings suggest that the DISCOVER cervical disc replacement for the treatment of cervical spondylotic myelopathy may yield good functional shortterm results, further follow-up is necessary to evaluate mid-and long-term outcome.%目的 探讨应用DISCOVER人工颈椎间盘置换治疗颈椎病的短期临床疗效.方法 采用DISCOVER人工颈椎间盘置换术治疗颈椎病患者12例,其中脊髓型8例,神经根型4例.统计并分析患者术前和术后1、6个月及末次随访时颈椎运动范围、置换节段活动度、相邻节段活动度进行影像学评估,术前及末次随访时NDI脊髓功能评分及颈部疼痛及上肢疼痛VAS评分进行临床疗效评估.结果 所有患者随访9～18个月,平均14个月.术后临床症状明显改善或消失,NDI评分由术前(54.2～13.2)%提高到末次随访时的(24.0～6.8)%(P＜0.01),颈部疼痛由术前的(5.6～1.8)分提高到末次随访时的(1.8±0.9)分,上肢疼痛由术前的(4.5±2.1)分提高到末次随访时的(1.0±0.5)分,有显著性差异(P＜0.01).按照Odom's评定标准,末次随访时:优8例,良3例,可1例,优良率91.7%.术后随访x线片示椎间隙高度及生理曲度恢复满意,术后1个月随访时颈椎运动范围、置换节段的活动度及相邻节段活动度较术前减少,有显著性改善(P＜0.01),但是术后半年及末次随访时恢复到术前水平,无显著性差异(P＜0.01).所有病例未发生脊髓及神经根损伤,无假体脱落及异位骨化等并发症发生.结论 应用DISCOVER人工椎间盘置换术治疗颈椎病早期临床疗效良好,中远期疗效有待进一步观察.
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