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华西医学  2011 

Bryan人工椎间盘单节段置换治疗颈椎间盘退变性疾病的临床疗效

, PP. 885-889

Keywords: 人工椎间盘,置换,颈椎,退变,随访

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Abstract:

【】 目的 评价Bryan人工椎间盘单节段置换治疗颈椎间盘退变性疾病的临床疗效。 方法 2004年11月―2008年4月,21例颈椎间盘退变突出并经保守治疗无效的患者接受Bryan人工颈椎间盘单节段置换术。患者术前、术后1、6、12、18、24个月时使用颈椎功能障碍指数(neckdisableindex,NDI)、症状程度主观评价、疼痛视觉模拟疼痛量表(visualanaloguescale,VAS)进行疗效评估,手术效果使用Odom法评价。影像学检查包括颈椎功能位X线片、颈椎CT及MRI检查。 结果 21例患者均顺利完成椎间盘置换手术,术后随访2年。患者对症状的主观评分,颈痛VAS评分、手臂疼痛VAS评分,NDI分别由术前的(2.80±0.42)、(4.62±1.84)、(5.01±1.79)、(22.60±4.88)分下降到随访终止时的(0.20±0.42)、(1.01±0.56)、(0.82±0.24)、(4.30±1.25)分。所有患者对手术效果Odom评级优良,8例(38.1%)自觉症状完全缓解。手术过程平均时间为(110.5±42.6)min,术中出血量平均为(166.0±108.8)mL。影像学评价见植入的人工椎间盘运动功能良好,未见颈椎不稳的表现。2例假体在术后早期轻度前移。 结论 Bryan人工椎间盘单节段置换是治疗颈椎间盘退变性疾病的一种安全有效的方法,术后随访2年临床疗效满意。【Abstract】 Objective ToevaluatetheclinicaltherapeuticeffectofsinglesegmentBryandiscreplacementoncervicaldiscdegenerativediseases. Methods FromNovember2004toApril2008,21patientswhohadapoorresponseafterconservativetreatmentfortheircervicaldiscdegenerationunderwentthesinglelevelBryandiscreplacement.Beforetheoperationand1,6,12,18,and24monthsaftertheoperation,allpatientswereevaluatedbyneckdisableindex(NDI),subjectivesymptomscale,visualanaloguescale(VAS)andOdomscore.TheradiologicalexaminationsincludedX-ray,CTscanandMRI. Results Operationsweresuccessfullyexecutedin21patients.Allpatientshadobeyedthefollow-upvisitingattheexpectedtimeinthenexttwoyearsaftertheoperation.Patients′symptomscale,VASforneckpain,VASforarmpain,NDIwere2.80±0.42,4.62±1.84,5.01±1.79,and22.60±4.88,respectivelybeforetheoperationandsignificantlydecreasedto0.20±0.42,1.01±0.56,0.82±0.24,and4.30±1.25,respectivelyattheendofthefollow-up.AllpatientshadgoodorhigherscoreoftheOdomscore.Theymptomswerecompletelyrelievedineightpatients(38.1%).Themeanoperationtimewas(110.5±42.6)minutes,theaveragebloodlosswas(166.0±108.8)mL.Thenormalmotionoftheartificialdiscwasobserved.Nocervicalinstabilitywasobserved.Twoprosthesismigratedslightly. Conclusion SinglesegmentalBryandiscreplacementissafeandeffectiveonthecervicaldiscdegeneration.Thetwo-yearfollow-uprevealesasatisfiedclinicaloutcome.

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