颈椎人工椎间盘置换早期临床报道

The early clinical report of cervical disc replacement in the management of spondylotic myelopathy

目的 探讨初期应用Bryan人工椎间盘系统治疗颈椎病的疗效。方法 2003年，12月～2005年2月应用Bryan人工椎间盘系统治疗脊髓型颈椎病和神经根型颈椎病患者17例。结果 随访5～15个月，平均10个月。无伤口感染病例，患者神经系统症状均有不同程度的改善，颈椎活动大部分接近正常。有1例术后3个月发现假体有轻度位移，但不超过2mm且没有明显的症状。JOA评分由术前平均8．5分提高到术后的15分，平均改善率为75％。术后1个月、3个月和6个月分别门诊随访时，拍摄颈椎正侧位和过屈过伸侧位X线片显示颈椎稳定性好，运动功能无明显丢失。未见假体周围异位骨化。结论 人工颈椎间盘置换为颈椎病的治疗提供了一个新的选择。

Objective To explore the effect of Bryan cervical disc replacement in the management of cervical spondylotic myelopathy （CSM）. Methods Between December 2003 and February 2005, 17 patients of CSM or cervical spondylotic radiculopathy were treated with Bryan cervical disc replacement. Results A follow-up was performed for 5-15 months （ mean 10 months）. No infected wound occurred, neurological symptoms of all the cases had been improved in different degree, and cervical spine restored almost normal. One case was found prosthesis drifted mildly （ 〈 2 mm） 3 months after operation without any symptom. JOA score increased from average 8.5 preoperatively to 15 postoperatively, and mean improved rate was 75%. Radiographic examination showed cervical spine was stable and the activity was also well. Heterotopic ossification was not found around the prosthesis. Conclusion Cervical disc replacement can achieve good therapeutic effect on anterior-decompression and stability of cervical spine, which is a new choice for the treatment of CSM.