Department of Spinal and Orthopaedic Surgery, The Third Hospital, Southern Medical University, Guangzhou, China.
Orthop Surg. 2009 Feb;1(1):52-7. doi: 10.1111/j.1757-7861.2008.00010.x.
To assess long-term clinical results of prosthetic disc nucleus (PDN) replacement for the treatment of lumbar disc herniation.
Seventy-two patients with lumbar disc herniation were implanted with a single PDN device from March 2002 to December 2003. Fifty-eight (80.6%) patients attended clinical, functional, and radiographic follow-up examinations for more than 48 months. Independent analysis was performed by careful review of the interviews, operative reports, preoperative and postoperative radiographs, and computed tomography scans or magnetic resonance imaging (MRI).
After implantation, a significant proportion of patients experienced pain relief. Improvements were noted in pain intensity, walking distance, neurological weakness, Oswestry and Prolo scores, intervertebral disc height and lumbar mobility. Intervertebral disc height was not well maintained, compared with the preoperative height it decreased 18% (P < 0.001). Several complications were associated with the implantation of PDN, including transient low-back pain, implant dislocation, malposition of the implant, damage to the end plates and subsidence of implant.
The clinical data show that PDN is preferred and can effectively increase the range of lumbar motion in patients with lumbar disc herniation. However, this study only represents cases in our centre.
评估人工髓核假体置换治疗腰椎间盘突出症的长期临床疗效。
2002 年 3 月至 2003 年 12 月，对 72 例腰椎间盘突出症患者植入单枚人工髓核假体。58 例（80.6%）患者的临床、功能和影像学随访时间超过 48 个月。通过仔细分析访谈、手术报告、术前和术后 X 线片以及计算机断层扫描或磁共振成像（MRI），对独立分析结果进行评估。
植入后，相当一部分患者疼痛得到缓解。疼痛强度、行走距离、神经无力、Oswestry 和 Prolo 评分、椎间盘高度和腰椎活动度均有改善。与术前高度相比，椎间盘高度的维持不理想，下降了 18%（P<0.001）。人工髓核假体植入后出现了一些并发症，包括短暂性腰痛、假体脱位、假体位置不当、终板损伤和假体下沉。
临床资料表明，人工髓核假体置换术在治疗腰椎间盘突出症方面具有一定优势，能有效增加腰椎活动度。但本研究仅代表本中心的病例情况。
