DISCOVER人工颈椎间盘置换术治疗脊髓型颈椎病的早期疗效观察

Observation on early therapeutic effect of DISCOVER artificial cervical disc replacement for cervical spondylotic myelopathy

目的探讨应用DISCOVER人工颈椎间盘置换术治疗脊髓型颈椎病的早期临床疗效。方法回顾性分析行DISCOVER人工颈椎间盘置换术的12例脊髓型颈椎病患者的临床资料，统计并分析患者术前和术后神经功能状态JOA评分和颈椎总活动度（ROM），进行早期疗效评估。结果所有患者随访6个月，术后临床症状和体征明显改善或消失，JOA评分由术前的（6．79±3．62）分提高到末次随访的（15．84±0．89）分（P〈0．05）；ROM术前为（51．3±14．2）°，术后末次随访为（49．9±13．8）°，差异无统计学意义（P〉0．05）。按照Odom评定标准，末次随访时，优9例，良2例，可1例，优良率91．7％。结论应用DISCOVER人工颈椎间盘置换术治疗脊髓型颈椎病早期疗效良好，远期效果有待进一步观察。

Objective To evaluate the early clinical efficacy of DISCOVER artificial cervical disc replacement sur- gery for cervical spondylotic myelopathy. Methods The clinical data of 12 patients with cervical spondylotic myelopathy undergoing DISCOVER artificial cervical disc replacement was analyzed retrospectively. Preoperative and postoperative neurological status JOA scores and cervical range of motion （ROM） were compared and early therapeutic efficacy was e- valuated. Results All patients were followed - up for 6 months. The neurological symptoms and signs were alleviated or disappeared in all cases. The JOA score was significantly improved from 6.79 ± 3.62 preoperatively to 15.84 ± 0.89 at the last postoperative follow - up （ P 〈 0.05 ）. No significant statistical difference was observed between preoperative cervical ROM and that at the last postoperative follow - up （51.3° ± 14.2°vs. 49.9° ± 13.8°, P 〉 0.05 ）. According to Odom criteria, 9 cases got excellent results, 3 cases got good results, 1 case got fair results. The rate of excellent and good results was 91.7%. Conclusion Our findings suggest that the DISCOVER cervical disc replacement for cervical spondylotie myelopathy may yield good short - term functional results. Further follow - up is necessary to evaluate mid - and long- term outcome.