Tsai Ming-Cheng, Liu Ya-Fang, Lin Wei-Hsing, Lee Ming-Chung
School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan.
Neurosurgical Department, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan.
J Clin Med. 2024 Apr 2;13(7):2048. doi: 10.3390/jcm13072048.
Anterior cervical discectomy and fusion (ACDF) is a standard procedure for degenerative diseases of the cervical spine, providing nerve decompression and spinal stabilization. However, it limits cervical spine motility, restricts fused segment activity, and may lead to adjacent degeneration. Cervical disc arthroplasty (CDA) is an accepted alternative that preserves the structure and flexibility of the cervical spine. This study aimed to explore the dynamic changes in the range of motion (ROM) of the cervical spine after CDA using a viscoelastic artificial disc, as well as the factors affecting mobility restoration. A retrospective analysis was conducted on 132 patients who underwent single-level anterior cervical discectomy and CDA from January 2015 to June 2022. Analysis of data from 132 patients revealed a significant improvement in clinical outcomes. The mean ROM of C2-C7 and functional spinal unit (FSU) segments significantly increased from 2 to 36 months post-operatively. Cervical spine flexibility was preserved and enhanced after prosthesis implantation. However, it took six months for the cervical spine motility to stabilize. In addition, sex and age were found to impact motility restoration, with female and younger patients exhibiting larger ROMs post-surgery. Additionally, CDA at the C5-C6 level resulted in the greatest increase in ROM, potentially improving overall kinematic ability. Single-segment artificial disc arthroplasty effectively restores the ROM in degenerative cervical spine conditions.
颈椎前路椎间盘切除融合术(ACDF)是治疗颈椎退行性疾病的标准手术,可实现神经减压和脊柱稳定。然而,该手术会限制颈椎活动度,限制融合节段的活动,还可能导致相邻节段退变。颈椎间盘置换术(CDA)是一种公认的替代方案,可保留颈椎的结构和灵活性。本研究旨在探讨使用粘弹性人工椎间盘进行CDA术后颈椎活动范围(ROM)的动态变化,以及影响活动度恢复的因素。对2015年1月至2022年6月期间接受单节段颈椎前路椎间盘切除及CDA的132例患者进行了回顾性分析。对132例患者的数据分析显示临床结果有显著改善。术后2至36个月,C2-C7和功能性脊柱单元(FSU)节段的平均ROM显著增加。假体植入后颈椎的灵活性得以保留并增强。然而,颈椎活动度需要六个月才能稳定。此外,研究发现性别和年龄会影响活动度恢复,女性和年轻患者术后的ROM更大。此外,C5-C6节段的CDA导致ROM增加最多,可能改善整体运动能力。单节段人工椎间盘置换术可有效恢复退行性颈椎疾病的ROM。