人工颈椎间盘置换术治疗脊髓型颈椎病的近期疗效

摘要

目的：探讨Bryan人工颈椎间盘置换术治疗脊髓型颈椎病的近期疗效。方法应用Bryan人工颈椎间盘置换术治疗26例脊髓型颈椎病患者，在术前及末次随访时的颈椎X线片上测量置换节段矢状位、冠状位活动度。应用JOA评分评价术后神经功能。结果术后患者症状均明显缓解。26例均获随访，时间29～48个月。末次随访JOA评分由术前平均8.3分±4．6分增加到16.1分±5.3分，置换节段矢状位活动范围4.3°～7.2°（5.6°±2.4°）；冠状位左右侧屈活动范围分别为3.1°～4.3°（3.8°±1.1°）和3.1°～4.6°（3.9°±0.9°）。随访期间假体无偏移松动或下沉，无置换节段假体周围异位骨化。结论 Bryan人工颈椎间盘置换术治疗脊髓型颈椎病近期临床效果较好，维持颈椎正常的活动范围、生理曲度和较好的生物力学稳定性。%Objective To discuss the short-term clinical and radiographic outcome of Bryan cervical disc arthroplas-ty.Methods Radiographic and clinical outcomes in 26 patients who received the Bryan cervical disc prosthesis were retrospectively reviewed.Static and dynamic X-ray was taken for measuring the range of motion.Clinical outcomes were assessed using Japanese Orthopedics Academy (JOA)scale.Results The average follow-up time was 29~48 months,and all patients were satisfied with the relief of symptoms.In the last follow-up,the average JOA scale was 16.1 ±5.3 ,while it was 8.3 ±4.6 pre-operation.The sagittal range of motion was 4.3°~7.2°(5.6°±2.4°),and the coronal range of motion was 3.1°~4.3°(3.8°±1.1°)and 3.1°~4.6°(3.9°±0.9°).No heterotopic ossifica-tion,prosthesis loosening,prosthesis migration or other complications occured.Conclusions Arthroplasty using the Bryan disc for cervical spondylotic myelopathy patients seems to be safe and provids encouraging clinical and radiolog-ic outcome in our short-term study.