颈椎动态稳定器治疗颈椎间盘突出症的临床效果评价

Clinical evaluation of dynamic cervical implant in treatment of cervical disc herniation

目的 评价颈椎动态稳定器（dynamic cervical implant DCI）治疗颈椎间盘突出症患者的临床效果.方法 2011年6月～2012年6月,应用颈椎前路椎间盘摘除,椎管减压结合动态稳定器（DCI）治疗颈椎间盘突出症患者22例（24个节段）,分别于术前和术后1、3、12个月进行JOA、ODI评分评价临床疗效,并行颈椎正侧位、动力位x线片检查,观察植入假体的稳定性及颈椎置换节段的活动度.结果 术后经过12个月的随访,JOA评分增高,ODI评分降低,临床症状较术前明显改善,虽然置换节段的活动度较术前有所减小,但仍保留了术前的部分活动范围,保持了颈椎的运动功能.影像学复查见颈椎生理弧度没有明显丢失,置换节段假体位置稳定无移位,未发现植入物下沉及手术节段的骨桥连接现象.结论 应用颈椎动态稳定器治疗颈椎间盘突出症,可以维持颈椎的动态稳定,保持颈前路减压的良好效果,早期临床效果较好.

Objective To evaluate the clinical efects of dynamic cervical implant（DCI）in the treatment of cervical disc herniation.Methods 22 patients with cervical disc herniation underwent diskectomy,decompression and internal fixation with DCI from June 2011 to June 2012.The clinical JOA and ODI scores were evaluated preoperatively and 1,3and12 months after surgery to observe the clinical effects.Plain radiography was taken to survey the intervertebral space height and mobility.Results Clinical symptoms was alleviated in all patients.Followed up at least 12 months,JOA and ODI scores were improved.Although the range of movement（ROM）of the post-operative replacement segment has been reduced compared with the preoperative,part of ROM remained in all patients.Replaced segment stability and cervical alignment were kept in all patients with no implant subsidence and displacement.No one was noted to have bone bridging at anterior site of surgical segment.Conclusion Treatment of cervical disc herniation by cervical functional reconstruction with DCI internal fixation,not only provides elastic dynamic stability,but can keep the good effect of anterior cervical decompression.Besides,the short-term curative effect is satisfactory.