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颈椎间盘疾病患者动态颈椎植入物的长期随访结果:与关节成形术相比。

Long-term Follow-Up Results of Dynamic Cervical Implant in Patients with Cervical Disk Diseases: Compared with Arthroplasty.

机构信息

Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China.

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, People's Republic of China.

出版信息

J Neurol Surg A Cent Eur Neurosurg. 2023 Sep;84(5):455-461. doi: 10.1055/a-1712-5386. Epub 2021 Dec 3.

Abstract

BACKGROUND

Arthroplasty has been proven to be a safe and effective treatment for patients with cervical degenerative disk disease (DDD). Dynamic Cervical Implant (DCI) has emerged as a novel implantation device for cervical DDD. This study aimed to compare the outcomes of these procedures after 5 years of follow-up in the DCI and arthroplasty groups.

METHODS

This study retrospectively enrolled 79 consecutive cervical DDD patients with 41 DCI and 47 prostheses implanted. Radiographs were analyzed for intervertebral height and range of motion (ROM). Neural function of the patients was assessed using the Neck Disability Index score, visual analog scale, Japanese Orthopaedic Association score and 36-Item Short Form Survey.

RESULTS

The DCI group had statistically lesser flexion/extension and bilateral bending ROM than the arthroplasty group at the operated level(s) ( < 0.05). The DCI group but not the orthoplast group showed improved lordotic alignment of C2-C7 and operated functional spinal unit ( < 0.05). No statistical difference was observed in the neural function of the two groups. Heterotopic ossification was found in 7 and 14 patients in the DCI and arthroplasty groups, respectively.

CONCLUSION

The 5-year follow-up results were comparable between the two groups. We believe that DCI implantation is a safe and effective procedure and could possibly become an alternative treatment for cervical DDD.

摘要

背景

关节成形术已被证明是治疗颈椎退行性椎间盘疾病(DDD)患者的安全有效的方法。动态颈椎植入物(DCI)已成为治疗颈椎 DDD 的新型植入装置。本研究旨在比较这两种手术在 5 年随访后的结果。

方法

本研究回顾性纳入了 79 例连续的颈椎 DDD 患者,其中 41 例接受了 DCI 治疗,47 例接受了假体植入。分析了影像学的椎间隙高度和活动度(ROM)。采用颈部残疾指数评分、视觉模拟评分、日本矫形协会评分和 36 项简短调查评估患者的神经功能。

结果

DCI 组在手术节段的屈伸和双侧弯曲 ROM 明显小于关节成形术组(<0.05)。DCI 组但不是矫形组显示 C2-C7 的后凸排列和手术功能单位得到改善(<0.05)。两组的神经功能无统计学差异。DCI 组和关节成形术组分别有 7 例和 14 例患者出现异位骨化。

结论

两组的 5 年随访结果相当。我们认为 DCI 植入是一种安全有效的方法,可能成为颈椎 DDD 的一种替代治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4197/10374355/a0149b057b15/10-1055-a-1712-5386-i213060oa-1.jpg

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