颈椎动态稳定器治疗颈椎病的早期临床效果

Early clinical effect of dynamic cervical implant in treatment of cervical spondylosis

目的观察应用颈椎动态稳定器（dynamic cervical implant,DCI）治疗椎间盘退变所致颈椎病的早期临床效果。方法 2010年4~6月,8例颈椎间盘突出症患者均行椎间盘切除、椎管减压后DCI置入。观察手术前后颈椎正侧位、过伸过屈侧位X线片,测量患者手术前后C2~7、置入节段和置入邻近节段的活动范围（range of motion,ROM）。采用视觉模拟评量表（visual analog scale,VAS）评分、患者满意度（patient satisfaction index,PSI）分别评价患者手术前后的症状改善情况和满意度。结果患者术后上肢VAS评分平均改善4.8分,颈部VAS评分平均改善4.6分,术后患者PSI平均为1.8,手术有效率为100%。颈椎C2~7的ROM减少15.76°±16.00°,差异有统计学意义（P〈0.05）;术后置入节段椎间隙的ROM减少2.14°±2.31°,差异有统计学意义（P〈0.05）;术后邻近节段的ROM减少1.18°±5.05°,差异无统计学意义（P〉0.05）。结论应用DCI治疗椎间盘退变所致颈椎病的早期疗效确切,能维持颈椎的稳定性并保留一定范围的生理活动度。

Objective To investigate the early clinical effect of dynamic cervical implant in the treatment of cervical spondylosis.Methods From April to June 2010,8 patients with cervical disc herniation underwent diskectomy,decompression and internal fixation with DCI.Pre-and postoperative roentgenographs were observed to measure range of motion（ROM） of C2~7,operative and adjacent segment.Visual analog scale（VAS） score and patient satisfaction index（PSI） were also evaluated.Results Compared with those before operation,the average VAS score improved 4.8 at upper limbs and 4.6 at neck after operation respectively.The average PSI was 1.8 one week after operation.Effective rate was 100%.The ROM of C2-7 decreased 15.76°±16.00°,and the difference was statistically significant（P0.05）.The ROM of implant segment decreased 2.14°±2.31°,and the difference was statistically significant（P0.05）.The ROM of adjacent segment decreased 1.18°±5.05°,and the difference wasn＇t statistically significant（P0.05）.Conclusion Treatment of cervical spondylosis caused by intervertebral disc degeneration by cervical functional reconstruction with DCI internal fixation is effective,and it gives consideration to both stability and ROM.