[单节段Bryan颈椎人工椎间盘置换术后异位骨化的有效性及发生率分析]

[Analysis of effectiveness and incidence of heterotopic ossification after single-level Bryan cervical artificial disc replacement].

作者信息

Liu Wenhua, Zhu Bing, Liu Xiaowei, Sun Yu

机构信息

Department of Spinal Surgery, the Affiliated Hospital of Weifang Medical College, Weifang Shandong, 261031, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Jun;26(6):699-702.

PMID:22792767

Abstract

OBJECTIVE

To evaluate the incidence of heterotopic ossification (HO) after single-level Bryan cervical artificial disc replacement, and to identify the relationship between HO and the effectiveness.

METHODS

The clinical data of 48 patients undergoing single-level Bryan cervical artificial disc replacement between October 2005 and October 2007 were reviewed retrospectively. There were 27 males and 21 females with an average age of 40.5 years (range, 33-51 years), including 8 cases of cervical myelopathy, 27 cases of nerve root cervical spondylosis, and 13 cases of mixed cervical spondylosis with an average disease duration of 10.3 months (range, 2-14 months). The involved segments included C3,4 in 3 cases, C4,5 in 6 cases, C5,6 in 30 cases, and C6,7 in 9 cases. The outcomes were evaluated using Visual Analogue Scale (VAS) score, the neck disability index (NDI), and cervical range of motion (ROM). According to patients with or without HO, 48 patients were divided into 2 groups (HO group and no HO group). VAS score, NDI, and cervical ROM were compared between 2 groups at 1, 2, 3, and 4 years after operation.

RESULTS

No severe complication occurred during and after operation in all patients. Forty-eight patients were followed up 48-72 months (mean, 56.6 months). VAS score and NDI were significantly improved when compared with preoperative values at all time points (P < 0.05); except at 3 days after operation, no significant difference was found in cervical ROM at the other time points when compared with preoperation (P > 0.05). Thirteen patients (27.08%) had HO at 4 years after operation, including 8 cases of grade 1, 3 cases of grade 2, and 2 cases of grade 3. There was no significant difference in VAS score, NDI, and cervical ROM between 2 groups at 1, 2, 3, and 4 years (P > 0.05).

CONCLUSION

The incidence of HO after single-level Bryan cervical artificial disc replacement is relatively high. However, HO has no effect on the cervical ROM and the effectiveness.

摘要

目的

评估单节段Bryan颈椎人工椎间盘置换术后异位骨化（HO）的发生率，并确定HO与疗效之间的关系。

方法

回顾性分析2005年10月至2007年10月期间接受单节段Bryan颈椎人工椎间盘置换术的48例患者的临床资料。其中男性27例，女性21例，平均年龄40.5岁（范围33 - 51岁），包括脊髓型颈椎病8例、神经根型颈椎病27例、混合型颈椎病13例，平均病程10.3个月（范围2 - 14个月）。受累节段包括C3、4 3例，C4、5 6例，C5、6 30例，C6、7 9例。采用视觉模拟评分法（VAS）、颈部功能障碍指数（NDI）及颈椎活动度（ROM）评估疗效。根据是否发生HO将48例患者分为2组（HO组和无HO组）。比较两组患者术后1、2、3和4年时的VAS评分、NDI及颈椎ROM。

结果

所有患者术中及术后均未发生严重并发症。48例患者随访48 - 72个月（平均56.6个月）。各时间点VAS评分和NDI与术前相比均显著改善（P < 0.05）；除术后3天外，其他时间点颈椎ROM与术前相比差异无统计学意义（P > 0.05）。术后4年有13例患者（27.08%）发生HO，其中1级8例，2级3例，3级2例。两组患者术后1、2、3和4年时的VAS评分、NDI及颈椎ROM差异无统计学意义（P > 0.05）。