Department of Neurosurgery, National Hospital of Neurology and Neurosurgery, Queen Square, London, England.
Neurosurgery. 2018 Sep 1;83(3):422-428. doi: 10.1093/neuros/nyx424.
Anterior cervical disc replacement is an alternative to fusion for the treatment of selected cases of radiculopathy and myelopathy. We report clinical and radiological outcomes after disc replacement with the NuNec™ artificial cervical disc (Pioneer® Surgical Technology, Marquette, Michigan) with subgroup analysis.
To review clinical and radiological outcomes after anterior cervical disc replacement with the NuNec™ artificial cervical disc.
A consecutive case series of patients undergoing cervical disc replacement with the NuNec™ artificial disc was conducted. Clinical outcomes were assessed by questionnaires preoperatively and up to 2 yr postoperatively including neck and arm pain, Neck Disability Index, Euroqol 5-dimensions, and Short Form-36; x-rays from the same period were analyzed for range of movement and presence of heterotopic ossification.
A total of 44 NuNec™ discs were implanted in 33 patients. Clinical improvements were seen in all outcomes; significant improvements on the Neck Disability Index, Euroqol 5-dimensions, and physical domain of the Short Form-36 were maintained at 2 yr. There was a mean of 4° range of movement at the replacement disc level at 2 yr, a significant reduction from baseline; there was also progression in levels of heterotopic ossification. Complications included temporary dysphagia (10%) and progression of disease requiring foraminotomy (6%); no surgery for adjacent level disease was required. There was no significant difference in the outcomes of the radiculopathy and myelopathy groups.
Clinical outcomes using the NuNec™ disc replacement are comparable with other disc replacements. Although the range of movement is reduced, the reoperation rate is very low.
颈椎前路椎间盘置换术是治疗特定神经根型颈椎病和脊髓型颈椎病病例的一种替代融合术式。我们报告使用 NuNec™人工颈椎间盘（Pioneer® Surgical Technology，密歇根州马凯特）进行椎间盘置换的临床和影像学结果，并进行亚组分析。
回顾使用 NuNec™人工颈椎间盘进行颈椎前路椎间盘置换的临床和影像学结果。
对连续的颈椎间盘置换患者进行了 NuNec™人工间盘的病例系列研究。使用问卷评估术前和术后 2 年的临床结果，包括颈部和手臂疼痛、颈椎残障指数、EuroQol 5 维度和简明健康调查问卷 36 版；同时分析同一时期的 X 射线以评估活动度和异位骨化的存在。
共植入 44 枚 NuNec™椎间盘，涉及 33 例患者。所有结果均显示出临床改善；颈椎残障指数、EuroQol 5 维度和简明健康调查问卷 36 版的生理领域在 2 年时保持显著改善。置换节段的平均活动度为 4°，与基线相比显著降低；异位骨化程度也有所进展。并发症包括暂时性吞咽困难（10%）和需要行神经孔切开术的疾病进展（6%）；无需行相邻节段手术。神经根型颈椎病和脊髓型颈椎病组的结果无显著差异。
使用 NuNec™椎间盘置换的临床结果可与其他椎间盘置换相媲美。尽管活动度降低，但再次手术率非常低。
