中国组织工程研究Issue(31)：4950-4956,7.DOI:10.3969/j.issn.2095-4344.2014.31.006
人工颈椎间盘置换与融合治疗颈椎病：中短期疗效的比较
Short-and medium-term efficacy of artificial cervical disc replacement versus fusion for cervical spondylosis
高明勇 1陶海鹰 1卫爱林 1贺斌1
作者信息
- 1. 武汉大学人民医院脊柱外科，湖北省武汉市 430060
- 折叠
摘要
Abstract
BACKGROUND:Recently, non-fusion technology representing as artificial cervical disc replacement continues to improve. On the basis of reconstruction of disc structure and function of involved segments, cervical spine structure of surgery area segment is significantly close to dynamic and static load stress distribution required by natural physiological systems. It effects are apparent in protecting intervertebral facet joints of degenerated segment and structure and function of the cervical spine of adjacent segments and in maintaining cervical dynamic stability, which presented obvious methodological strengths compared with segmental fusion technology. <br> OBJECTIVE:To evaluate the clinical outcomes of anterior cervical discectomy and fusion and Bryan artificial cervical disc replacement in the treatment of single-level cervical spondylotic myelopathy or radiculopathy. <br> METHODS:A total of 43 middle and old age patients with single-level cervical spondylotic myelopathy or radiculopathy, who were treated from March 2010 to March 2012, were enrol ed in this study. They were randomly assigned to anterior cervical discectomy and fusion group (fusion group) and Bryan artificial cervical disc replacement group. Range-of-motion of cervical overal and adjacent intervertebral area near the intervertebral space was observed with radiography. During fol ow-up, postoperative recovery of neurological function was evaluated using Japanese Orthopaedic Association scale, visual analog scale and neck disability index. <br> RESULTS AND CONCLUSION:None patients experienced complications of neurovascular injury during and after the surgery. Range-of-motion of postoperative overal cervical vertebra and adjacent joint was improved in the Bryan artificial cervical disc replacement group compared with the fusion group. Neurological function was apparently improved after surgery in each group. At 3 months after surgery, scores of Japanese Orthopaedic Association, visual analog scale and neck disability index were significantly improved in the Bryan artificial cervical disc replacement group compared with the fusion group (P<0.05). During final fol ow-up, there were significant differences in visual analog scale scores between the two groups. Japanese Orthopaedic Association scale score and neck disability index score were similar between the two groups. During fol ow-up, no prosthesis sinking, displacement or heterotopic ossification were detected. These data indicated that artificial cervical disc replacement could effectively keep the range of motion of cervical segments and protect disc degeneration of adjacent segment. Mid-term fol ow up obtained similar improvement of neurological function of fusion surgery. The moderate-term and short-term efficacies of non-fusion technology were better than fusion technology in the treatment of single-level cervical spondylopathy.关键词
植入物/人工假体/颈椎病/脊柱融合/椎间盘切除/人工椎间盘/活动范围Key words
cervical vertebrae/internal fixators/spinal fusion/diskectomy分类
医药卫生引用本文复制引用
高明勇,陶海鹰,卫爱林,贺斌..人工颈椎间盘置换与融合治疗颈椎病：中短期疗效的比较[J].中国组织工程研究,2014,(31):4950-4956,7.
