颈椎动态稳定器在颈椎病治疗中的应用

Dynamic cervical implant in the treatment of cervical spondylosis

目的 探讨应用颈椎动态稳定器（dynamic cervical implant，DCI）治疗颈椎病的安全性及早期临床疗效。方法 2011年9月～2012年5月施行颈前路减压DCI植入术的患者11例，统计手术时间和术中出血量；观察有无手术并发症的发生；采用疼痛视觉模拟评分法（visual analogue score，VAS）和颈椎功能障碍指数（neck disability index，NDI）评分量表评估患者术前和术后的症状，按日本骨科协会（Japanese orthopaedic association，JOA）评分行术前、术后神经功能评估。结果 11例患者均得到随访，其中手术时间（63.9±20.1） min；术中出血量（58.4±22.1） ml；无切口感染，植入物松动、移位、断裂，手术节段异位骨化及颈椎后凸畸形等并发症发生；术后3个月的疼痛VAS和NDI评分与术前比较明显减小，差异有统计学意义（P＜0.05）；末次随访的JOA评分与术前及术后3个月比较有明显升高，差异有统计学意义（P＜0.05）。 结论 颈前路减压DCI植入术治疗颈椎病在减轻疼痛、恢复神经功能方面是安全有效的，且近期临床疗效满意。

Objective To evaluate the safety and short-term clinical curative effect of dynamic cervical implant（DCI） in the treatment of cervical spondylosis. Methods From September 2011 to May 2012, 11 patients were treated by anterior cervical decompression and DCI implantation. The amount of bleeding and surgical duration were counted, and surgical complication was recorded. The pain visual analogue score （VAS） and neck disability index （NDI） scale were adopted to evaluate pre- and post-operative symptoms, and Japanese orthopaedic association （JOA） score was adopted to evaluate pre- and post-operative nerve function. Results All 11 cases were followed up. The amount of bleeding and the surgical duration were （58.4±22.1） ml and （63.9±20.1） min respectively. Incision infection, implant loosening, dislocation or breakage, operation segment heterotopic ossification, cervical kyphosis and other complications were not found. The 3 months postoperative pain VAS and NDI score were significantly reduced when compared with the preoperative one （P〈0.05）. The last follow-up JOA score had significantly increased compared with the preoperative one and the one 3 months after the surgery （P〈0.05）. Conclusion Anterior cervical decompression and DCI implantation in the treatment of cervical spondylosis is safe and effective in Pain relif. recovery of neurological function, and the short-term clinical curative effect is satisfactory.