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柏林夏里特医院人工椎间盘置换术:美国一家中心60例前瞻性随机病例报告。

SB Charité disc replacement: report of 60 prospective randomized cases in a US center.

作者信息

McAfee Paul C, Fedder Ira L, Saiedy Samer, Shucosky Erin M, Cunningham Bryan W

机构信息

Spine and Scoliosis Center, St Joseph's Hospital, Baltimore, Maryland 21204, USA.

出版信息

J Spinal Disord Tech. 2003 Aug;16(4):424-33. doi: 10.1097/00024720-200308000-00016.

Abstract

Sixty patients with one-level discogenic pain confirmed by plain radiography, magnetic resonance imaging, and provocative discography for degenerative disc disease were randomized: one-third BAK anterior interbody fusion and two-thirds anterior SB Charité artificial disc replacement. The mean age was 40.3 years (range 21-56 years). Nineteen cases were at L4-L5 and 41 cases were at L5-S1. Nineteen cases had BAK anterior interbody fusion and 41 cases were randomized as SB Charité disc replacement. The length of surgery was mean 88.4 minutes (range 54-137 minutes) for both groups. The estimated blood loss was mean 289.5 mL (range 50-1800 mL). The length of hospital stay was a mean of 3.03 days (range 2-6 days). Oswestry Disability Index scores for the SB Charité disc (aggregate study group) were 50.0 +/- 14.3 preoperatively and 25.0 +/- 20.1 at 1-3 years' follow-up (P < 0.001). This is the first study that shows improvement of functional outcome measures in a prospective randomized design with disc arthroplasty treating primarily mechanical back pain and achieving comparable successful results to lumbar fusion-interbody fusion cage and BMP or interbody autograft and pedicle screw instrumentation.

摘要

通过X线平片、磁共振成像以及椎间盘造影确诊为单节段椎间盘源性疼痛的60例退行性椎间盘疾病患者被随机分组:三分之一接受BAK前路椎间融合术,三分之二接受前路SB Charité人工椎间盘置换术。平均年龄为40.3岁(范围21 - 56岁)。19例位于L4 - L5,41例位于L5 - S1。19例接受BAK前路椎间融合术,41例被随机分配接受SB Charité椎间盘置换术。两组手术时间平均为88.4分钟(范围54 - 137分钟)。估计失血量平均为289.5 mL(范围50 - 1800 mL)。住院时间平均为3.03天(范围2 - 6天)。SB Charité椎间盘(汇总研究组)术前Oswestry功能障碍指数评分为50.0±14.3,1 - 3年随访时为25.0±20.1(P < 0.001)。这是第一项以前瞻性随机设计显示椎间盘置换术可改善功能结局指标的研究,该研究主要治疗机械性背痛,并取得了与腰椎融合术(椎间融合器和骨形态发生蛋白或椎间自体骨移植及椎弓根螺钉内固定)相当的成功结果。

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