Li Hong-ke, Zhang Chang-jiang, Wang Ming-jun, Yang Xian-yu, Li Lai-hao
Zhongguo Gu Shang. 2015 Nov;28(11):1026-31.
To compare the early clinical effects of Activ C cervical disc replacement (ACDR) and anterior cervical discectomy and fusion (ACDF) in treating single-level cervical spondylosis.
The clinical data of 76 patients with single-level cervical spondylosis underwent surgery from July 2009 to September 2012 were retrospectively analyzed. Among them, 28 patients were treated with ACDR (ACDR group), including 18 males and 10 females, aged from 32 to 62 years old with an average of (45.2±6.2) years; and 48 patients were treated with ACDF (ACDF group), including 28 males and 20 females, aged from 33 to 60 years old with an average of (45.8±6.4) years. Visual analogue scale (VAS), Japanese Orthopedics Association (JOA) score, Short Form-36 (SF-36), imaging data were used to assess the clinical effects after operation.
A total of 76 patients were followed up from 6 to 24 months with an average of 13.2 months. VAS of neck pain and brachialgia were improved in all patients after operation (P<0.05), there was no significant difference between two group (P>0.05). Somato-score and psycho-score of SF-36 of two groups were obviously increased (P<0.05), ACDR group was better than that of ACDF group (P<0.05). In ACDR group, there was no significant difference in the range of motion of surgical segments and adjacent segments between preoperative and postoperative (P>0.05); heterotopic ossification around the edge of vertebral body occurred in 1 case on the 6th month after operation, no fusion was found on the 1st year after operation. In ACDF group, the adjacent vertebral disease occurred in 1 case and the patient underwent the reoperation.
Activ C cervical disc replacement can reduce the degeneration of adjacent segments and its early outcomes for the treatment of single-level cervical spondylosis are satisfactory, but the long-term effects still need study.
比较Activ C人工颈椎间盘置换术（ACDR）与颈椎前路椎间盘切除融合术（ACDF）治疗单节段颈椎病的早期临床效果。
回顾性分析2009年7月至2012年9月行手术治疗的76例单节段颈椎病患者的临床资料。其中，28例采用ACDR治疗（ACDR组），男18例，女10例，年龄32～62岁，平均（45.2±6.2）岁；48例采用ACDF治疗（ACDF组），男28例，女20例，年龄33～60岁，平均（45.8±6.4）岁。采用视觉模拟评分法（VAS）、日本骨科学会（JOA）评分、简明健康状况调查量表（SF-36）、影像学资料评估术后临床效果。
76例患者均获随访，随访时间6～24个月，平均13.2个月。术后所有患者颈部疼痛及臂丛神经痛的VAS评分均改善（P<0.05），两组间比较差异无统计学意义（P>0.05）。两组SF-36的躯体评分和心理评分均明显升高（P<0.05），ACDR组优于ACDF组（P<0.05）。ACDR组手术节段及相邻节段术前、术后活动度比较差异无统计学意义（P>0.05）；术后6个月有1例椎体边缘出现异位骨化，术后1年未发现融合。ACDF组有1例出现相邻节段病变并再次手术。
Activ C人工颈椎间盘置换术可减少相邻节段退变，治疗单节段颈椎病的早期效果满意，但长期效果仍需研究。
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