腰椎人工椎间盘与人工髓核置换的临床比较

Analysis of comparing artificial disc replacement with artificial nucleus replacement in lumbar

目的 :探讨腰椎人工椎间盘与人工髓核置换治疗腰椎间盘突出症的临床应用价值及差异。方法 :对 2 0 0 0年 5月至 2 0 0 3年 4月行人工腰椎间盘置换的 7例与行人工髓核置换的 2 5例患者进行比较分析。结果 :行人工腰椎间盘置换的 7例患者平均随访 2 1个月 (12～ 33个月 ) ,临床评价 :优 6例 ,良 1例 ;行人工髓核置换的 2 5例患者平均随访 12个月 (6～ 18个月 ) ,临床评价 :优 18例 ,良 4例 ,尚可 2例 ,另有一例术后 2个月出现假体移位并症状复发 ,后再次手术更换假体。结论 :腰椎人工椎间盘与人工髓核置换均可恢复椎间隙高度 ,且近期疗效满意 ,但后者手术易操作 ,创伤小 ,费用低 ,更为术者和患者所接受。

Objective: To explore the difference and clinical value of artificial disc replacement and artificial nucleus replacement in lumbar for the treatment of lumbar disc herniation. Method: The comparative analysis was performed in 7 patients treated with artificial disc replacment and 25 patients treated with artificial nucleus replacement from May 2000 to April 2003. Result: 7 patients treated with artificial disc replacement were followed up with an average of 21 months(12～33 months). The clinical outcomes were excellent in 6 cases, good in 1 case. 25 patients treated with artificial nucleus replacement were followed up with an average of 12 months(6～18 months). The clinical outcomes were excellent in 18 cases, good in 4 cases, fair in 2 cases. And the migration of the prosthesis was found in one patient whose clinical symptoms recurred 2 months later after surgery. So another operation was done to replace it. Conclusion: Both artificial disc replacement and artificial nucleus replacement can restore the intervertebral height and acquire the satisfactory short-term clinical result. But the latter is more acceptable by the surgeons and patients for its easier operating, less damage and cost.