Jiang Yu, Tian Ye, Wang Yi-peng, Qiu Gui-xing, Weng Xi-sheng, Feng Bin
Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chines Academy of Medical Science, Beijing 100730, China.
Zhonghua Wai Ke Za Zhi. 2012 Mar;50(3):243-6.
To investigate the mid-term radiological outcome of sagittal alignment of overall cervical spine and the functional spinal unit after replacement surgery with Bryan cervical disc prosthesis.
Eighteen patients with cervical disc disorder were performed cervical disc replacement with 20 Bryan discs from November 2005 to May 2010, including single-level 16 cases and bi-level 2 cases. The patient consisted of 13 males and 5 females with age ranging from 38 to 59 years (average, (47 ± 6) years). Fourteen cases with overall cervical lordotic alignment and segmental lordotic alignment per-operatively (group 1) and 4 others with segmental kyphotic alignment and overall cervical kyphotic alignment per-operatively (group 2). The overall sagittal alignment (C(2-7)) and segmental sagittal alignment were measured pre-operatively, post-operatively and at final follow-up to evaluate the outcome.
All cases obtained the follow-up with an average of (24 ± 5) months (range 12 to 53 months). To the mean overall cervical alignment, there were 9.9° ± 1.9° per-operatively, 12.8° ± 2.1° post-operatively and 11.6° ± 1.8° at final follow-up in group 1 and -1.8° ± 0.8° per-operatively, 7.3° ± 1.3° post-operatively and 5.0° ± 2.1° at final follow-up in group 2. There were statistical significance between per-operatively and post-operatively (t = -2.987 and -5.058, P < 0.05) and no statistical significance between post-operatively and final follow-up (P > 0.05) in both groups. To the mean segmental alignment there were 2.6° ± 0.8° per-operatively, 5.4° ± 1.0° post-operatively and 4.3° ± 0.9° at final follow-up in group 1 and -3.0° ± 0.8° per-operatively, 3.8° ± 1.3° post-operatively and 0.3° ± 2.8° at final follow-up in group 2. There were statistical significance between per-operatively and post-operatively in both groups (t = -3.829 and -4.086, P < 0.05) and between post-operatively and final follow-up in group 1 (t = 2.630, P < 0.05)but not in group 2 (P > 0.05).
The Bryan cervical disc prosthesis has a good mid-term outcome for maintaining sagittal alignment of overall cervical spine and the functional spinal unit. Long-term follow-up should be needed to assess the long-term functionality of the prosthesis.
探讨采用Bryan颈椎间盘假体置换术后颈椎整体矢状位排列及功能脊柱单元的中期影像学结果。
2005年11月至2010年5月，对18例颈椎间盘疾病患者行颈椎间盘置换术，共植入20枚Bryan假体，其中单节段16例，双节段2例。患者中男性13例，女性5例，年龄38至59岁（平均（47±6）岁）。术中14例颈椎整体呈前凸排列且节段性前凸（第1组），另外4例术中节段性后凸且颈椎整体后凸（第2组）。术前、术后及末次随访时测量颈椎整体矢状位排列（C2-7）及节段性矢状位排列以评估结果。
所有病例均获随访，平均随访时间为（24±5）个月（范围12至53个月）。第1组颈椎整体平均排列角度术中为9.9°±1.9°，术后为12.8°±2.1°，末次随访时为11.6°±1.8°；第2组术中为-1.8°±0.8°，术后为7.3°±1.3°，末次随访时为5.0°±2.1°。两组术中与术后比较均有统计学意义（t=-2.987和-5.058，P<0.05），术后与末次随访比较均无统计学意义（P>0.05）。第1组节段平均排列角度术中为2.6°±0.8°，术后为5.4°±1.0°，末次随访时为4.3°±0.9°；第2组术中为-3.0°±0.8°，术后为3.8°±1.3°，末次随访时为0.3°±2.8°。两组术中与术后比较均有统计学意义（t=-3.829和-4.086，P<0.05），第1组术后与末次随访比较有统计学意义（t=2.630，P<0.05），第2组无统计学意义（P>0.05）。
Bryan颈椎间盘假体在维持颈椎整体矢状位排列及功能脊柱单元方面中期效果良好。需长期随访以评估假体的长期功能。
