人工颈椎间盘置换术治疗脊髓型颈椎病10例临床分析

Artificial cervical disc replacement in the treatment of cervical spondylotic myelopathy clinical analysis of 10 cases

目的探讨人工颈椎间盘置换术用于治疗脊髓型颈椎病的临床疗效。方法 2010年6月—2012年9月,对10例保守治疗无效患者的11个节段进行了人工颈椎间盘置换术,男6例,女4例;年龄41～61岁,平均(48±0.8)岁。单节段9例,双节段1例,术后随访3～12个月。结果所有患者伤口均I期临床愈合,术中及术后没有神经和血管损伤的并发症,结合术前术后颈椎活动范围检查、神经系统症状、Odom评级、JOA评分及影像学检查,患者神经系统症状均获得满意改善,JOA评分较术前明显升高。颈椎曲度、置换节段功能活动度、置换节段上下位椎体椎间隙高度得到保持。假体未见下沉或偏移,未见异位骨化。结论颈椎人工椎间盘置换术在维持节段运动功能的同时,可取得良好的神经减压效果,人工椎间盘置换术的短中期疗效是令人满意的。

@@@@ Objective To investigate the artificial cervical disc replacement for the treatment of cervical spondylotic myelopathy. Methods In 2010 June to 2012 September,10 cases of invalid conservative treatment of patients with 11 segments for the artificial cervical disc replacement,6 cases were male,4 female;age 41-61 years,mean 48±0.8 years old. 9 cases of single segment,1 cases of double segments,followed up for 3 months to 12 months. Results All patients were healed wound phase I clinical,intraoperative and postoperative no nerve and blood vessel injury,combined examination of cervical range check, neurological symptoms,Odom rating,JOA score and imaging before and after surgery,patients with nervous system symptoms were satisfactory improvement,JOA score was significantly higher than that before operation. Cervical curvature,replacement of segmental function activity,replacement segment inferior vertebral height is maintained. Prosthesis no sinking or offset, no heterotopic ossification. Conclusion Cervical artificial disc replacement in the maintenance of segmental motion function at the same time,can obtain good effect of nerve decompression,the short term curative effect of artificial disc replacement is satisfactory.