颈椎人工椎间盘置换术的临床和影像学结果：超过三年的随访队列研究。

Clinical and radiographic results of cervical artificial disc arthroplasty: over three years follow-up cohort study.

机构信息

Department of Spine Surgery, Beijing Jishuitan Hospital, Fourth Clinical Medical College of Peking University, Beijing 100035, China.

出版信息

Chin Med J (Engl). 2010 Nov;123(21):2969-73.

PMID:21162939

Abstract

BACKGROUND

Theoretic advantages of cervical disc arthroplasty include preservation of normal motion and biomechanics in the cervical spine, and reduction of adjacent-segment degeneration. The clinical and radiographic effects of cervical disc arthroplasty in short term have been ascertained. The aim of this study is to research the data of mid-term results.

METHODS

In this prospective cohort study, 50 patients who underwent cervical disc arthroplasty from December 2003 to January 2006 were enrolled. There were 39 patients who received 1-level disc arthroplasty, and 11 patients received 2-level disc arthroplasty, with an average age of 50.9 years (range from 29 to 73). The median follow-up was 41.85 months (range from 36.00 - 55.63 months). Patients were followed prospectively with respect to their symptoms, neurologic signs, and radiographic results.

RESULTS

The median value of Japanese Orthopaedic Association (JOA) score was 14.0 before surgery, and 16.5 at the most recent follow-up (P < 0.01). The median value of the recovery rate of the JOA score was 92.2%. The preoperative range of motion (ROM) at the indexed level was (10.40 ± 4.97)°, which has significantly correlated with the most recent follow-up ROM which was (8.56 ± 4.76)° (P < 0.05, r = 0.33). The ROM at the operative level at the most recent follow-up was greater than the value at the 3-month follow-up of (7.52 ± 3.37)° (P < 0.05). The preoperative functional spinal unit (FSU) angulation was (-0.96 ± 6.52)°, which was not significantly correlated with that of the most recent follow-up value of (-2.65 ± 7.95)° (P < 0.01, r = 0.53). The preoperative endplate angulation was (2.61 ± 4.85)°, which had no significant correlation with that of the most recent follow-up value of (0.71 ± 6.41)° (P > 0.05).

CONCLUSIONS

The clinical and radiographic results of cervical disc arthroplasty are good in mid-term follow-up. The normal range of motion of the operated level and the biomechanics in the cervical spine are well preserved.

摘要

背景

颈椎间盘置换术的理论优势包括保留颈椎的正常运动和生物力学，减少相邻节段的退化。颈椎间盘置换术的短期临床和影像学效果已经确定。本研究的目的是研究中期结果的数据。

方法

本前瞻性队列研究纳入了 2003 年 12 月至 2006 年 1 月期间接受颈椎间盘置换术的 50 例患者。其中 39 例接受 1 个节段的椎间盘置换术，11 例接受 2 个节段的椎间盘置换术，平均年龄 50.9 岁（29-73 岁）。中位随访时间为 41.85 个月（36.00-55.63 个月）。前瞻性随访患者的症状、神经体征和影像学结果。

结果

术前日本矫形协会（JOA）评分中位数为 14.0 分，末次随访时为 16.5 分（P<0.01）。JOA 评分恢复率的中位数为 92.2%。术前索引节段活动度（ROM）为（10.40±4.97）°，与末次随访时的（8.56±4.76）°有显著相关性（P<0.05，r=0.33）。末次随访时手术节段 ROM 大于术后 3 个月时的（7.52±3.37）°（P<0.05）。术前功能脊柱单位（FSU）角为（-0.96±6.52）°，与末次随访时的（-2.65±7.95）°无显著相关性（P<0.01，r=0.53）。术前终板角为（2.61±4.85）°，与末次随访时的（0.71±6.41）°无显著相关性（P>0.05）。