颈椎动态稳定器置入治疗颈椎病5例:非融合术后弹性动态固定效果随访

Dynamic cervical implant replacement in the treatment of cervical disease in 5 cases:Follow-up results of elastic dynamic stability after anterior cervical decompression and non-fusion

背景：前路椎间盘切除减压融合术是颈椎病手术治疗的有效方法,但在长期的临床实践中也出现了很多问题。目的：探讨颈椎动态稳定器在颈椎非融合手术中的安全性及有效性。方法：5例颈椎病患者（6个节段）行颈前路椎间盘切除减压置入颈椎动态稳定器进行非融合手术,术前及术后3d、3个月、6个月进行JOA评分,观察神经功能恢复情况,并摄X射线平片观察椎间隙高度及椎间活动度。结果与结论：经1~6个月随访,JOA平均评分由术前8.5分升至术后15.4分;影像学复查未见颈椎动态稳定器移位、下沉,生理弧度良好,颈椎运动范围得到一定保持,无明显颈部僵硬和活动受限表现。提示颈椎动态稳定器一体化植入术后能获得弹性动态固定,并恢复和维持椎间隙高度及椎间活动度,近期疗效满意。

BACKGROUND： Anterior cervical discectomy and fusion is an effective method for the operative treatment of cervical disease, but some problems appear in long-term clinical practice. OBJECTIVE： To evaluate the security and availability of the dynamic cervical implant （DCI） used in the anterior cervical decompression non-fusion. MATHODS： A total of 5 patients （6 segments） with cervical disease were treated by anterior decompression and replaced by DCI. The JOA score was evaluated preoperatively and 3 days, 3 and 6 months after surgery to observe the recovery of neurological function. Plain radiography was taken to survey the intervertebral space height and mobility. RESULTS AND CONCLUSION： All cases were followed up for 1-6 months. JOA average score increased from 8.5 points to 15.4 points. The prosthesis curve was good. Replaced segment achieved stability and restored partial of normal rang of motion. Cervical stiffness and limitation of activity were not found. The implantation of DCI not only provides elastic dynamic stability, but also restores and sustains intervertebral space height and mobility. Besides, the short-term curative effect is satisfactory.