Bryan与ProDisc-C全椎间盘置换术治疗单节段颈椎症状性退行性椎间盘疾病的比较。

Comparison of Bryan versus ProDisc-C total disk replacement as treatment for single-level cervical symptomatic degenerative disk disease.

作者信息

Zhang Zhenxiang, Jiao Lei, Zhu Wei, Du Yaqing, Zhang Wenjie

机构信息

Orthopedic Department, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou, 225300, Jiangsu, People's Republic of China.

出版信息

Arch Orthop Trauma Surg. 2015 Mar;135(3):305-11. doi: 10.1007/s00402-014-2149-7. Epub 2015 Jan 3.

Abstract

PURPOSE

The purpose of this retrospective trial was to compare the role of the Bryan with ProDisc-C total disk replacement (TDR).

MATERIALS AND METHODS

Data were collected before surgery and 1, 3, 6, 12, and 24 months after surgery. Disability and pain were assessed using the Neck Disability Index (NDI) and the Visual Analog Scale of the neck and of the arm pain. SF-36 outcome measures were obtained including the physical component score as well as the mental component score. Functional spinal unit (FSU) was examined on lateral radiographs at 24-month follow-up. Occurrences of heterotopic ossification (HO) were detected from 24-month follow-up X-rays.

RESULTS

The mean NDI, mean VAS, and mean SF-36 scores were not statistically different between groups before surgery and at 24-month follow-up. At 24 months: Bryan 49 and ProDisc-C 53 (P > 0.05). The FSU angle increased slightly for the Bryan group (from 0.7 to 0.8°, P > 0.05), while for the ProDisc-C group, it increased significantly (from 0.5 to 2.3°, P < 0.05). There were 2 additional operations in this series: 1 in the Bryan group and 1 in the ProDisc-C group. There were no intraoperative complications, no vascular or neurologic complications, no spontaneous fusions, and no device failures or explantation. No significant difference was noted in terms of HO formation.

CONCLUSION

Both the Bryan and the ProDisc-C TDR resulted in satisfactory clinical outcome. Moreover, Bryan TDR can maintain the lordosis of FSU, whereas ProDisc-C TDR can restore the lordosis of FSU, whether or not this radiographic evidence leads to more favorable clinical outcome for ProDisc-C TDR requires further investigation.

摘要

目的

本回顾性试验的目的是比较Bryan人工椎间盘与ProDisc-C人工椎间盘全椎间盘置换术(TDR)的作用。

材料与方法

在手术前以及术后1、3、6、12和24个月收集数据。使用颈部功能障碍指数(NDI)以及颈部和手臂疼痛的视觉模拟量表评估功能障碍和疼痛情况。获得SF-36结局指标,包括身体成分评分以及心理成分评分。在24个月随访时通过侧位X线片检查功能脊柱单元(FSU)。从24个月随访的X线片中检测异位骨化(HO)的发生情况。

结果

术前和24个月随访时,两组之间的平均NDI、平均视觉模拟量表评分和平均SF-36评分无统计学差异。在24个月时:Bryan组为49,ProDisc-C组为53(P>0.05)。Bryan组的FSU角度略有增加(从0.7°增加到0.8°,P>0.05),而ProDisc-C组则显著增加(从0.5°增加到2.3°,P<0.05)。本系列中有另外2例手术:Bryan组1例,ProDisc-C组1例。无术中并发症、无血管或神经并发症、无自发融合、无器械故障或取出。在HO形成方面未发现显著差异。

结论

Bryan人工椎间盘和ProDisc-C人工椎间盘全椎间盘置换术均产生了令人满意的临床结果。此外,Bryan人工椎间盘全椎间盘置换术可维持FSU的前凸,而ProDisc-C人工椎间盘全椎间盘置换术可恢复FSU的前凸,这种影像学证据是否会导致ProDisc-C人工椎间盘全椎间盘置换术获得更有利的临床结果需要进一步研究。

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