| 许浩,李锋,廖晖,等.颈椎动态稳定器治疗颈椎病的短期疗效观察.骨科,2016,7(4): 225-229. |
| 颈椎动态稳定器治疗颈椎病的短期疗效观察 |
| Short-term effect of dynamic cervical implant arthroplasty in the treatment of cervical spondylosis |
| 投稿时间：2015-12-07 |
| DOI：10.3969/j.issn.1674-8573.2016.04.001 |
| 中文关键词: 颈椎 椎间盘移位 假体和植入物 治疗结果 |
| 英文关键词: Cervical vertebrae Intervertebral disk displacement Prostheses and implants Treatment outcome |
| 基金项目:国家自然科学基金（81472133）；卫生行业科研专项项目基金（201002018） |
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| 中文摘要: |
| 目的 探讨颈椎动态稳定器（dynamic cervical implant, DCI）植入术治疗因颈椎间盘病变引起的颈椎病的安全性及有效性。方法 回顾性分析2012年2月至2014年12月于我院行颈椎DCI植入术的23例患者（男15例，女8例）的临床资料和早期随访情况。应用疼痛视觉模拟量表（visual analogue scale, VAS）评分、日本骨科协会（Japanese Orthopaedic Association, JOA）17分评分法、颈椎功能障碍指数（neck disability index, NDI）评分和术后Odom评级评价患者的临床症状缓解情况。影像学检查测量各时间点手术节段椎间隙高度（disc height，DH）、手术节段的活动度（range of motion, ROM）、手术节段脊柱功能单位（functional spinal unit, FSU）的角度（Cobb’s角）和颈椎整体角度（C2~7 Cobb’s角）。结果 DCI手术时间，单节段为（70.55±13.43） min，双节段为（153.45±12.66） min；术中失血量，单节段为（109.20±16.22） ml，双节段为（166.75±15.30） ml。患者术后及各随访时间段JOA评分较术前均显著增加；术后及各随访时间段NDI评分、VAS评分与术前相比均显著降低。DCI植入节段的ROM、DH和FSU Cobb’s角术后随访时与术前比较均显著增加。以上差异均具有统计学意义（均P＜0.05）。C2~7 Cobb’s角随访时与术前相比稍有增加，但差异无统计学意义（P＞0.05）。结论 DCI植入术治疗颈椎病既保留了手术节段的活动度，又降低了异位骨化率，并且DCI假体可以遏制因过度运动造成的小关节退变加速。患者症状缓解明显，短期临床疗效令人满意。其中远期疗效亟待进一步的研究。 |
| 英文摘要: |
| Objective To discuss the safety and effectiveness of dynamic cervical implant (DCI) arthroplasty in the treatment of cervical spondylosis. Methods The retrospective study enrolled 23 patients (15 males and 8 females) with cervical spondylosis who underwent DCI arthroplasty between February 2012 and December 2014. Patients were then followed up for more than 1 year. Clinical evaluation adopted included the visual analogue scale (VAS) scores, Japan Orthopaedic Association (JOA) score, neck disability index (NDI), and Odom rating. Radiological assessments adopted included disc height (DH), segmental range of motion (ROM), FSU Cobb’s angle, and overall Cobb’s angle (C2-C7). Results The average operation time of single-level and two-levels were respectively (70.55±13.43) min and (153.45±12.66) min. The blood loss of single-level and two-levels were respectively (109.20±16.22) ml and (166.75±15.30) mL. The JOA and VAS scores, and NDI were improved significantly after surgery. The ROM at the treatment level, DH, and FSU Cobb’s angle increased significantly after surgery. But the C2-C7 Cobb’s angle was not increased significantly. Conclusion The results indicate that DCI arthroplasty in treatment of cervical spondylosis is effective. It can retain the segmental motion, reduce the heterotopic ossification and also alleviate the degeneration of the small joints. However, there is no definitive evidence to prove whether DCI arthroplasty has good medium-and-long term efficacy. |
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