Cody John P, Kang Daniel G, Tracey Robert W, Wagner Scott C, Rosner Michael K, Lehman Ronald A
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Building 19, Bethesda, MD 20889, USA.
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Building 19, Bethesda, MD 20889, USA.
J Clin Neurosci. 2014 Nov;21(11):1901-4. doi: 10.1016/j.jocn.2014.05.008. Epub 2014 Jul 1.
Cervical disc arthroplasty has emerged as a viable technique for the treatment of cervical radiculopathy and myelopathy, with the proposed benefit of maintenance of segmental range of motion. There are relatively few, non-industry sponsored studies examining the outcomes and complications of cervical disc arthroplasty. Therefore, we set out to perform a single center evaluation of the outcomes and complications of cervical disc arthroplasty. We performed a retrospective review of all patients from a single military tertiary medical center undergoing cervical disc arthroplasty from August 2008 to August 2012. The clinical outcomes and complications associated with the procedure were evaluated. A total of 219 consecutive patients were included in the review, with an average follow-up of 11.2 (±11.0)months. Relief of pre-operative symptoms was noted in 88.7% of patients, and 92.2% of patients were able to return to full pre-operative activity. There was a low rate of complications related to the anterior cervical approach (3.2% with recurrent laryngeal nerve injury, 8.9% with dysphagia), with no device/implant related complications. Symptomatic cervical radiculopathy is a common problem in both the civilian and active duty military populations and can cause significant disability leading to loss of work and decreased operational readiness. There exist several surgical treatment options for appropriately indicated patients. Based on our findings, cervical disc arthroplasty is a safe and effective treatment for symptomatic cervical radiculopathy and myelopathy, with a low incidence of complications and high rate of symptom relief.
颈椎间盘置换术已成为治疗神经根型颈椎病和脊髓型颈椎病的一种可行技术，其益处在于可维持节段活动度。目前相对较少有非行业资助的研究来探讨颈椎间盘置换术的疗效和并发症。因此，我们着手对颈椎间盘置换术的疗效和并发症进行单中心评估。我们对一家军队三级医疗中心在2008年8月至2012年8月期间接受颈椎间盘置换术的所有患者进行了回顾性研究。评估了与该手术相关的临床疗效和并发症。共有219例连续患者纳入研究，平均随访时间为11.2（±11.0）个月。88.7%的患者术前症状得到缓解，92.2%的患者能够恢复到术前的全部活动水平。与颈前路手术相关的并发症发生率较低（喉返神经损伤为3.2%，吞咽困难为8.9%），未出现与器械/植入物相关的并发症。症状性神经根型颈椎病在 civilian 和现役军人中都是常见问题，可导致严重残疾，进而导致工作丧失和作战准备状态下降。对于有适当指征的患者，存在多种手术治疗选择。根据我们的研究结果，颈椎间盘置换术是治疗症状性神经根型颈椎病和脊髓型颈椎病的一种安全有效的方法，并发症发生率低，症状缓解率高。 （注：原文中“civilian”未明确翻译指向，根据语境推测可能是指普通民众，但翻译准确性存疑，仅供参考）
