Mobi-C人工颈椎间盘置换的临床疗效和影像学分析

Clinical and radiographic study on Mobi-C cervical disc replacement

[目的]分析Mobi-C人工颈椎间盘置换治疗颈椎病的临床疗效和影像学改变,探讨其重建或保留椎间高度及颈椎整体、置换节段、临近节段活动度的作用。[方法]回顾2009年10月～2010年6月本科收治的行Mobi-C单节段人工颈椎间盘置换术的颈椎病患者31例,其中获得完整随访资料的22例。于术前、术后7d,术后1、3、6、12、24个月行临床评估和影像学数据采集。使用Odom评级、VAS评分、JOA评分、NDI评分评估临床疗效及神经功能的改善情况;通过颈椎正侧位、动力位X线片观察椎间高度及颈椎整体、置换节段、临近节段、脊柱功能单位(FSU)的活动度。[结果]22例患者获得完整随访,随访时间24～30个月,平均26.3个月。与术前相比,24个月随访时,VAS评分、JOA评分、NDI评分均有改善(P>0.05)。术后颈椎活动度、FSU活动度、置换节段及临近节段活动度维持了术前水平。置换节段椎间高度均有恢复,上下临近节段椎间高度维持术前水平。[结论]使用Mobi-C人工颈椎间盘假体行椎间盘置换术临床效果可靠,影像学资料显示术后可重建或保留椎间高度及颈椎整体、置换节段、临近节段活动度。

[ Objective] To analyze the clinical outcome and radiographic changement with Mobi -C artificial cervical disc replacement for the treatment of cervical spondylosis, and study its role on reconstructing or maintaining the intervertebral height, the ROM of cervical spine, treated segment, adjacent segments and functional spinal unit （ FSU ） . [ Methods ] Thirty - one patients undergoing single level Mobi - C disc replacement from October 2009 to June 2010 were reviewed, including 22 cases of complete follow - up data. Clinical and radiographic date was collected before replacement and at 7 days, 1, 3, 6, 12 and 24 months postoperatively. Clinical and neurological outcome was evaluated by Odom＇ s criteria, VAS, JOA and NDI scores. Static and dynamic cervical radiographs were measured to determine the intervertebral height, the ROM of the cervical spine, treated segment, adjacent segments and functional spinal unit （FSU） . [ Results ] All 22 cases were completed followed up from 24 months to 30 months （ averaged 26. 3 months） . Compared with the preoperative one, VAS , JOA , NDI score showed statistical significant improvements at 24 month follow - up （ P 〉 0.05 ） . The ROM of cervical spine, treated segment, adjacent segments and functional spinal unit （FSU） had no significant difference when compared with those of the preoperative after replace- ment. Intervertebral height of treated segment was significantly improved , and intervertebral height of adjacent segments showed no statistical significance between each time point of follow up. [ Conclusion ] The clinical outcome of Mobi - C artificial cervi- cal disc replacement is reliable, and radiographic date showed its role of reconstructing or maintaining the intervertebral height, the ROM of cervical spine, treated segment, adjacent segments and functional spinal unit （ FSU ） after operation.