人工间盘置换治疗颈椎病近期疗效及并发症分析

Analysis of Recent Curative Effects and Complications on Artificial Disc Replacement in the Treatment of Cervical Spondylosis

目的：评估15例Bryan人工颈椎间盘置换术治疗颈椎病的近期疗效,分析容易出现的并发症。方法：2011年1月至2013年10月,我院和镇江康复医疗集团医院、自治区中医院共同完成15例单节段Bryan人工颈椎间盘置换术,其中男6例,女9例;年龄33~57岁,平均45.2岁。脊髓型颈椎病7例,神经根型颈椎病6例,混合型2例。结果：全部病例随访6~18个月,平均随访13.2月。脊髓型颈椎病患者术前JOA评分为（8.5±1.0）分,末次随访时为（15.5±1.0）分,与术前比较有显著性差异（P〈0.01）。颈痛视觉评分（VAS）、颈肩障碍疼痛指数（NDI）与术前相比均具有统计学意义（P〈0.05）。神经根型颈椎病患者的症状完全消失。所有病例未见假体下沉、移位以及症状加重者。1例患者术后14个月随访时发现假体周围有异位骨化形成,2例术后置换节段出现颈椎曲度反曲后凸,随访后无明显改善。结论：Bryan人工颈椎间盘置换术治疗颈椎间盘疾患可取得良好的临床疗效,由于其手术操作较为复杂,并发症发生率较多,应重视手术适应证的选择和规范的手术操作。

Objective： Appraised 15 examples Bryan artificial neck intervertebral disc replaces the short-term curative effect which the technique treatment cervical vertebra gets sick, the complication which the analysis often appears. Methods： From January,2011 to October, 2013,my courtyard and Zhenjiang Recovery Medical service Group Hospital,the autonomous region Chinese medicine hospital together completes 15 example single stage Bryan artificial neck intervertebral disc to replace the technique, in which male 6 examples, female 9 examples; Age 33~57 year old, average 45.2 years old.The spinal cord cervical vertebra gets sick 7 examples,the nerve root cervical vertebra gets sick 6 examples, the mixed 2 examples. Results： All patients were followed up for 6~18 months, average 13.2 months follow-up. Spinal cord type of cervical spondylosis patients before JOA score（8.5±1）%, at last follow-up for（15.5±1）,there was significant difference as compared with that before operation（P〈0.01）.Neck pain visual analogue scale（VAS）, the neck shoulder disorders pain index（NDI） compared with the preoperative were statistically significant（P〈0.05）.Nerve root type cervical spondylosis symptoms completely disappeared. In all cases, no prosthesis subsidence, displacement and symptoms increase. In 1 patients after 14 months follow-up found around the prosthesis had heterotopic ossification,2 cases after replacement segment cervical curvature retrorsely kyphosis, no significant improvement of follow-up. Conclusion： Bryan artificial cervical disc replacement in the treatment of cervical disc disease can obtain good clinical curative effect, because the operation is complicated, the complication rate is more, should pay attention to the operation to operation operation certificate selection and specification.