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动态颈椎植入物置换治疗单节段退行性颈椎间盘疾病的临床和影像学结果:24个月随访

Clinical and radiographic outcomes of dynamic cervical implant replacement for treatment of single-level degenerative cervical disc disease: a 24-month follow-up.

作者信息

Wang Lei, Song Yue-ming, Liu Li-ming, Liu Hao, Li Tao

机构信息

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.

出版信息

Eur Spine J. 2014 Aug;23(8):1680-7. doi: 10.1007/s00586-014-3180-7. Epub 2014 Jan 29.

Abstract

PURPOSE

To determine the role of dynamic cervical implant (DCI) replacement for single-level degenerative cervical disc disease in Chinese patients.

METHODS

Thirty patients with single-level degenerative cervical disc disease were prospectively enrolled between April 2010 and August 2010 (12 women, 18 men; mean age 56.5 years). All patients underwent anterior cervical decompression, DCI replacement, clinical and radiological assessments preoperatively and at 1, 6, 12, and 24 months postoperatively, and Japanese Orthopaedic Association (JOA), Visual Analogue Scale (VAS), Neck Disability Index (NDI), and Short Form 36 (SF-36) scores. Lateral neutral radiographs provided the intervertebral space height. Lateral dynamic radiographs were taken to measure the range of motion (ROM) of the cervical spine and functional spinal unit (FSU) of the treated segment. We compared the amount of motion of the adjacent vertebral endplate and the intrinsic motion of the implant and calculated a correlation analysis.

RESULTS

DCI showed good clinical and radiographic outcomes. At the final follow-up, JOA, VAS, NDI, and SF-36 average scores improved significantly. The intervertebral space height increased slightly after operation and was maintained during follow up. The ROM of the cervical spine and FSU decreased at early follow-up, but recovered to the preoperative level within 1-2 years. There was a high index of linear correlation between the motion of the adjacent vertebral endplate and the intrinsic motion of the implant.

CONCLUSIONS

DCI provided elastic dynamic stability for the targeted segment, and restored and sustained intervertebral space height and ROM of the cervical spine.

摘要

目的

确定动态颈椎植入物(DCI)置换术在中国单节段退变性颈椎间盘疾病患者中的作用。

方法

前瞻性纳入2010年4月至2010年8月期间的30名单节段退变性颈椎间盘疾病患者(12名女性,18名男性;平均年龄56.5岁)。所有患者均接受了颈椎前路减压、DCI置换术,并在术前以及术后1、6、12和24个月进行了临床和影像学评估,记录日本骨科协会(JOA)评分、视觉模拟量表(VAS)评分、颈部功能障碍指数(NDI)和简明健康调查问卷36项量表(SF-36)评分。通过颈椎中立位侧位X线片测量椎间隙高度。拍摄颈椎动态侧位X线片以测量颈椎的活动范围(ROM)以及治疗节段的功能脊柱单元(FSU)。我们比较了相邻椎体终板的活动量与植入物的固有活动度,并进行了相关性分析。

结果

DCI显示出良好的临床和影像学结果。在末次随访时,JOA、VAS、NDI和SF-36的平均评分均显著改善。术后椎间隙高度略有增加,并在随访期间保持稳定。颈椎和FSU的ROM在早期随访时降低,但在1 - 2年内恢复到术前水平。相邻椎体终板的活动与植入物的固有活动度之间存在高度线性相关指数。

结论

DCI为目标节段提供了弹性动态稳定性,并恢复和维持了颈椎的椎间隙高度及ROM。

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