颈前路人工椎间盘置换术治疗脊髓型颈椎病的临床疗效分析

Analysis of Clinical Efficacy of Mobi-C Artificial Disc Replacement via Anterior Cervical Approach for the Treatment of Cervical Spondylotic Myelopathy

【目的】探讨颈椎Mobi—C人工椎间盘置换术（ADR）治疗脊髓型颈椎病的近期临床疗效。【方法】回顾性分析本科2008年2月至2011年3月收治的22例脊髓型颈椎病手术病例，均行单节段Mobi—C人工椎间盘置换术，随访时间为12～15个月，平均随访13．5个月，均摄颈椎磁共振及术前、术后及末次随访时的颈椎正侧位及颈椎过伸过屈位x线片，测量置换节段活动度（ROM），采用JOA评分评价患者神经功能改善情况；采用NDI评分及VAs评分评价患者生活质量。【结果】所有病例末次随访MobiC人工椎间盘假体无松动、塌陷。置换间隙术前活动度为9．74°±2．12°，术后1年时为9．96°±2．01°，与术前比较无统计学差异（P〉0．05）。术前JOA评分为（7．56±2．21）分，术后1年为（15．10±1．29）分，前后比较有统计学意义（P〈0．05），术前NDI评分为（38．90±3．92）分，术后1年为（27．30±3．14）分，前后比较有统计学意义（P〈0．05），术前VAS评分为（5．20±1．31）分，术后1年为（3．10±1．24）分，前后比较有统计学意义（P〈0．05）。【结论】颈椎Mobi—C人工椎间盘置换术治疗脊髓型颈椎病近期疗效满意。

[Objective] To explore the short-term efficacy of Mobi-C artificial disc replacement（ADR） via anterior cervical approach for the treatment of cervical spondylotic myelopathy. [Methods] A total of 22 patients with cervical spondylotic myelopathy admitted to our department from Feb. 2008 to March 2011 were analyzed retrospectively. All patients underwent single-segment Mobi-C ADR. The follow up time was 12-15 months with the average of 13.5 months. Radiographs including magnetic resonance image, X-ray films from C-spine PA and LAT and cervical hyperextension and hyperflexion position before and after surgery and the last time were taken. The range of motion （ROM） on segments of disc replacements was measured. The improvement of neurological function of patients was evaluated by JOA score. NDI and VAS score were used to evaluate the quality of life of patients. [Results] No prosthesis loosening and collapse were observed in all patients with Mobi-C ADR at the last time of follow up. The ROM of replacement interspace before and one year after operation were （7.53 ± 2.21） and （15.10 ±1.29） scores, respectively, but there was no significant difference（ P 〉0.05）. The NDI score before and one year after operation were （38.90 ±3.92） and （27.30 ±3.14） scores, respectively, and there was significant difference（ P 〈0.05）. The VAS before and one year after operation were （5.20± 1.31） and （3.10 ± 1.24） scores, respectively, and there was significant difference（ P d0.05）. [Conclusion] Follow up results indicate that cervical Mobi-C ADR for the treatment of cervical spondylotic myelopathy has satisfactory short-term efficacy.