Coric Domagoj, Finger Frederick, Boltes Peggy
Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina 28207, USA.
J Neurosurg Spine. 2006 Jan;4(1):31-5. doi: 10.3171/spi.2006.4.1.31.
The authors report on a prospective randomized controlled multicenter trial in which they compared the clinical outcomes obtained in patients who underwent the placement of a Bryan Cervical Disc System with those obtained in patients who underwent anterior cervical discectomy and fusion (ACDF). In the present study, they evaluated the safety and effectiveness of the artificial disc based on data obtained at a single investigational site.
Patients with primary, single-level cervical disc disease producing radiculopathy and/or myelopathy were randomized prospectively to undergo anterior cervical discectomy with either fusion or artificial disc placement. The patients were evaluated with pre- and postoperative serial radiographic studies; the authors also evaluated neck disability indices, visual analog scale scores for pain, 36-Item Short Form Health Survey scores, and neurological status at 1.5, 3, 6, 12, and 24 months. Analysis of the early results obtained in the 33 patients indicated an absence of device-related complications. Preliminary analysis revealed that improvement in all clinical outcome measures was excellent for both treatment groups; however, in patients treated with the artificial cervical disc, motion at the treated level was maintained.
The preliminary results documented at this investigational site are encouraging. Evaluation of data acquired in the Bryan disc treatment group showed that improvements in the clinical parameters were similar to those in the fusion group. Additionally in the artificial disc-treated group, there was radiographic evidence that motion was maintained. It is theorized that motion preservation may potentially reduce the rate of adjacent-level cervical disc disease that has been documented in patients who undergo ACDF.
作者报告了一项前瞻性随机对照多中心试验,比较了接受Bryan颈椎间盘系统植入术的患者与接受颈椎前路椎间盘切除融合术(ACDF)的患者的临床结果。在本研究中,他们基于在单个研究地点获得的数据评估了人工椎间盘的安全性和有效性。
将患有原发性单节段颈椎间盘疾病并伴有神经根病和/或脊髓病的患者前瞻性随机分组,分别接受颈椎前路椎间盘切除融合术或人工椎间盘植入术。对患者进行术前和术后系列影像学检查;作者还评估了颈部功能障碍指数、疼痛视觉模拟量表评分、36项简短健康调查评分以及在1.5、3、6、12和24个月时的神经状态。对33例患者早期结果的分析表明没有与器械相关的并发症。初步分析显示,两个治疗组在所有临床结局指标上的改善都非常好;然而,接受人工颈椎间盘治疗的患者,治疗节段的活动得以维持。
该研究地点记录的初步结果令人鼓舞。对Bryan椎间盘治疗组获得的数据评估表明,临床参数的改善与融合组相似。此外,在人工椎间盘治疗组中,有影像学证据表明活动得以维持。理论上,保留活动可能会降低接受ACDF的患者中已被记录的相邻节段颈椎间盘疾病的发生率。