Ogon Michael, Howanietz Norbert, Tuschel Alexander, Chavanne Albert, Meissner Jochen, Becker Stephan
Orthopädische Abteilung III, Wirbelsäulenchirurgie, Orthopädisches Spital Speising, Wien, Osterreich.
Oper Orthop Traumatol. 2007 Jun;19(2):209-30. doi: 10.1007/s00064-007-1203-9.
To eradicate treatment-resistant lower back pain caused by painful degeneration of the intervertebral disks. To avoid the disadvantages of alternative fusion surgery, especially degenerative wear and tear on adjacent segments, by maintaining the mobility of the affected motion segments.
Treatment-resistant lower back pain due to painful degeneration of the intervertebral disks ("degenerative disk disease").
Spondylolisthesis, scoliosis, osteoporosis, infection, spinal stenosis, degeneration of the vertebral articulations.
The intervertebral disk is excised through an anterior approach. It is essential to retain good mobility of the motion segment, if necessary, by resection of the posterior longitudinal ligament. After revitalization of the vertebral base and cover plates and chiseling of a groove for the keel of the prosthesis, the upper and lower prosthetic plates are inserted and the polyethylene inlay is locked into place.
From April 2002 to May 2004, 36 ProDisc (Synthes Spine, West Chester, PA, USA) modular intervertebral disk prostheses were implanted in 34 patients (26 women, eight men, average age 44.3 years). Clinical evaluation was based on the visual analog scale (VAS), the Oswestry Disability Index (ODI), and the SF-36 Questionnaire. Follow-up assessment also included radiographic views of the lumbar spine in two planes in flexion and extension and standing. The follow-up interval for all patients was at least 1 year and 2 years for 14 patients. 26 patients were very satisfied with the operation, five patients were satisfied, and three patients were less satisfied. The clinical parameters recorded on the VAS, ODI and SF-36 improved from 7.4 to 2.8 (VAS), 48.0 to 13.1 (ODI) and 31.3 to 44.2 (SF-36, Physical Component Summary Score) from the time of the preoperative assessment to the 1-year follow-up. The range of motion at the segment with the implanted prosthesis was 10 degrees on average at L4/5 and 7 degrees on average at L5/S1 1 year postoperatively.
根除因椎间盘疼痛性退变引起的顽固性下背痛。通过保持受影响运动节段的活动度，避免替代融合手术的缺点，尤其是相邻节段的退变磨损。
因椎间盘疼痛性退变（“椎间盘退变疾病”）导致的顽固性下背痛。
椎体滑脱、脊柱侧弯、骨质疏松、感染、椎管狭窄、椎间关节退变。
通过前路切除椎间盘。如有必要，通过切除后纵韧带，保持运动节段良好的活动度至关重要。在椎体基部和盖板恢复活力并为假体龙骨凿出凹槽后，插入上下假体板，并将聚乙烯嵌体锁定到位。
2002年4月至2004年5月，34例患者（26名女性，8名男性，平均年龄44.3岁）植入了36枚ProDisc（美国宾夕法尼亚州韦斯特切斯特市Synthes Spine公司）模块化椎间盘假体。临床评估基于视觉模拟量表（VAS）、Oswestry功能障碍指数（ODI）和SF-36问卷。随访评估还包括腰椎在屈伸和站立位两个平面的X线片。所有患者的随访间隔至少为1年，14例患者为2年。26例患者对手术非常满意，5例患者满意，3例患者不太满意。从术前评估到1年随访时，VAS、ODI和SF-36记录的临床参数从7.4改善至2.8（VAS）、48.0改善至13.1（ODI）以及31.3改善至44.2（SF-36，身体成分汇总评分）。术后1年，植入假体节段的活动度在L4/5平均为10度，在L5/S1平均为7度。
