生物骨科材料与临床研究2018，Vol.15Issue(2)：14-18,5.DOI:10.3969/j.issn.1672-5972.2018.02.004
人工颈椎间盘置换联合前路减压融合术治疗多节段颈椎病的临床疗效分析
Clinical study of artificial cervical disc replacement combined with anterior cervical decompression and fusion for multi-level cervical spondylosis
龚全 1娄纪刚 1刘浩 1孟阳 1洪瑛 2王贝宇1
作者信息
- 1. 四川大学华西医院骨科,四川成都,610041
- 2. 四川大学华西医院手术室,四川成都,610041
- 折叠
摘要
Abstract
Objective To explore the clinical effects of artificial cervical disc replacement combined with anterior cervical decompression with fusion in treatment of patients with multi-level cervical spondylosis.Methods A total of 18 patients who underwent artificial cervical disc replacement combined with anterior cervical decompression and fusion were eligible for this respectively reviewing study from Jun 2009 to Apr 2013,including 7 males and 11 females,with a mean age of 47.1 (37 ～ 59 years).Among these 18 patients underwent hybrid surgery (HS),11 cases underwent artificial cervical disc replacement (ACDR) combined with anterior cervical disectomy and fusion (ACDF),7 cases underwent ACDR combined with anterior cervical corpectomy and fusion (ACCF).Clinical outcomes were determined by Japanese orthopaedic association (JOA),neck disability index (NDI) and visual analogue scale (VAS).Radiographic parameters including angular range of motion (ROM) of arthroplasty,C2～ C7 and adjacent segments were measured by X-ray.Fusion rate,implant-related complication and heterotopic ossification were also observed by CT scan.Results All patients received 18 to 54 months follow-up,with an average of 26.3 months.The JOA,NDI and VAS scores were significantly decreased during the follow up periods compared with pre-operation respectively (P＜0.05).At 24 months post-operation,compared with pre-operation,ROM ofarthroplasty (8.37°±2.77° vs 8.23°±3.36°),arthroplasty adjacent segment (9.16°±2.72° vs 9.41 °±2.72°) both showed no significant difference (P＞0.05);however ROM of C2～ C7 (41.71 °±6.99° vs 44.91 °±9.48°)and fusional adjacent segment (9.43°±2.6° vs 8.18°±2.42°) were detected with significant difference (P＜0.05).At 12 month post-operation,all segments underwent fusion surgery received solid fusion;during postoperative follow-up implant-related complication and heterotopic ossification were not detected.Conclusion Artificial cervical disc replacement combined with anterior cervical decompression and fusion is a safe and effective altemative for multilevel cervical spondylosis in terms of satisfactory pain relief,NDI recovery and cervical ROM preservation.关键词
多节段/颈椎病/人工椎间盘置换/混合手术Key words
Multilevel/Cervical spondylosis/Artificial disc replacement/Hybrid surgery分类
医药卫生引用本文复制引用
龚全,娄纪刚,刘浩,孟阳,洪瑛,王贝宇..人工颈椎间盘置换联合前路减压融合术治疗多节段颈椎病的临床疗效分析[J].生物骨科材料与临床研究,2018,15(2):14-18,5.
