| 人工椎间盘置换治疗颈椎间盘突出症 |
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Received:October 17, 2023
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| 作者 | Author | 单位 | Unit | E-Mail |
| 崔玉明 |
CUI Yu-ming |
江苏省镇江瑞康医院骨科, 江苏 镇江 212000 |
Department of Orthopaedics, Zhenjiang Ruikang Hospital of Jiangsu Province, Zhenjiang 212000, Jiangsu, China |
cui.ym@163.com |
| 刘方刚 |
LIU Fang-gang |
江苏省镇江瑞康医院骨科, 江苏 镇江 212000 |
Department of Orthopaedics, Zhenjiang Ruikang Hospital of Jiangsu Province, Zhenjiang 212000, Jiangsu, China |
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| 期刊信息：《中国骨伤》2024年37卷，第11期，第1051-1055页 |
| DOI：10.12200/j.issn.1003-0034.20230459 |
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目的: 探讨人工颈椎间盘置换术对颈椎间盘突出症的临床疗效。
方法: 回顾性分析2016年7月至2022年7月收治的颈椎间盘突出患者24例24个节段,男12例,女12例;年龄36~68(50±2)岁;置换前病变节段椎间隙高度椎间隙高度4.3~7.2(5.6±1.6) mm,前屈后伸活动范围5.6°~7.2°(6.4±1.3)°,左右侧屈活动范围10.2°~11.4°(10.7±1.8)°,日本骨科学会(Japanese Orthopaedic Association,JOA)评分为8~13(8.0±0.3)分。取颈前路手术,颈椎间盘切除及减压后行人工颈椎间盘置换术。
结果: 术后所有患者切口Ⅰ期愈合。24例获得随访,时间12~60(33±12)个月。末次随访时置换节段椎间隙高度4.0~6.8(5.4±1.3) mm,前屈后伸活动范围4.6~6.4(5.6±1.2)°,左右侧屈活动范围8.7~10.3(9.5±1.5)°。假体无移位或下沉,手术节段发生轻微异位骨化(Ⅰ-Ⅱ级),置换节段相邻椎间隙高度无丢失,相邻节段活动度手术前后对比无明显变化。JOA评分由置换前(8.0±0.3)分增加到置换后平均(15.0±0.2)分。
结论: 人工颈椎间盘置换术不仅可获得与颈椎前路融合术等同的临床疗效,而且避免了手术相邻节段的代偿性应力增加,保持了相邻节段生物力学环境的稳定,因而减少了手术相邻节段退变的发生率,可以作为治疗颈椎间盘突出症的有效方法,但人工颈椎间盘置换术的长期疗效和存在的问题有待进一步研究解决。 |
| [关键词]:颈椎间盘突出症 人工颈椎间盘置换 颈椎病 |
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| Artificial disc replacement for the treatment of cervical disc herniation |
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Abstract:
Objective To investigate the clinical efficacy of artificial cervical disc replacement for cervical disc herniation.
Methods Retrospective analysis of 24 patients with cervical disc herniation with 24 segments admitted from July 2016 to July 2022,including 12 males and 12 females,with an average age of (50±2) years old ranging from 36 to 68 years old. The intervertebral space height of the lesion segment before replacement was 4.3 to 7.2 mm with an average of (5.6±1.6) mm,the range of motion of anterior flexion and posterior extension was 5.6° to 7.2° with an average of (6.4±1.3)°,the range of motion for the left and right lateral flexion was 10.2° to 11.4° with an average of (10.7±1.8)°,and the Japanese Orthopaedic Association (JOA) score was 8 to 13 scores with an average of (8.0±0.3) scores. Through anterior incision,artificial cervical disc replacement surgery was performed after cervical discectomy and decompression.
Results After surgery,all patients'incisions healed well. All patients were followed up from 12 to 60 months with an average of (33±12) months. At the final follow-up,the intervertebral space height of replacement segment was 4.0 to 6.8 mm with an average of (5.4±1.3) mm,the range of motion of anterior flexion and posterior extension was 4.6° to 6.4°with an average of (5.6±1.2)°,the range of motion of left and right lateral flexion was 8.7°to 10.3°with an average of (9.5±1.5)°. The prosthesis did not shift or sink,slight heterotopic ossification occurred within the operative segment(ⅠorⅡgrade). The height of adjacent intervertebral spaces was not lost,there was no vertebral degeneration,no significant change in the comparison of adjacent segment mobility before and after surgery. The JOA score increased from (8.0±0.3) scores before replacement operation to (15.0±0.2) scores after operation.
Conclusion Artificial cervical disc replacement surgery can not only obtain the same efficacy as the anterior cervical disc fusion surgery,but also avoid the increase of compensatory stress of adjacent segments,maintain the stability of the biomechanical environment,thereby reducing the incidence of degeneration of adjacent segments,and can be used as an effective method for the treatment of cervical disc herniation,,but the long-term efficacy and the existing problems of replacement surgery need to be further studied and solved in the future. |
| KEYWORDS:Cervical disc herniation Artificial cervical disc replacement Cervical spondylosis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 崔玉明,刘方刚.人工椎间盘置换治疗颈椎间盘突出症[J].中国骨伤,2024,37(11):1051~1055 |
| 英文格式: | CUI Yu-ming,LIU Fang-gang.Artificial disc replacement for the treatment of cervical disc herniation[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(11):1051~1055 |
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