颈椎间盘置换治疗颈椎病术后相邻节段退变的临床观察

Adjacent segment degeneration after treatment of cervical spondylosis with cervical disc replacement versus fusion

[目的]观察颈椎间盘置换治疗颈椎病术后相邻节段退变的临床疗效。[方法]采用随机分配法将2010年7月～2013年7月来本院进行治疗的80例患者随机分为两组,置换组采用颈椎间盘置换术进行治疗,融合组采用前路颈椎间盘切除融合术,术后在不同时间对两组患者进行随访,分析两组患者术后相邻节段退变情况。[结果]置换组患者的JOA评分较术前相比平均提高了5.33分,与融合组的5.27分比较差异无统计学意义;对邻近节段颈椎间盘的退变情况分析,得出在最后一次随访时即术后24个月时,置换组有7例出现退变,退变率为17.5%,融合组有14例出现退变,退变率为35.0%,两组均无死亡患者。[结论]颈椎间盘置换治疗颈椎病在具有良好疗效的同时,降低了相邻节段的退变率,值得在临床上推广应用。

[Objective] To investigate the avoiding effect for adjacent segment degeneration after treatment of cervical spondylosis with cervical disc replacement. [Methods] From July 2010 to July 2013,80 patients with cervical disease randomly received treatment of cervical disc replacement（ experiment group,n = 40 cases） and anterior cervical discectomy fusion（ control group,n = 40 cases）. The adjacent segment degeneration were observed and compared between two groups at different time points after surgery. [Results] In the experiment group,the postoperative JOA score improved by an average of 5. 33 points,showing no significant difference when compared with 5. 27 points in the control group（ P〉0. 05）. At last follow- up（ 24 months after surgery） observation,seven cases of adjacent segment of cervical disc degeneration were found in the experiment group,rated 17. 5% in the total,while 14 cases of degeneration were noted in the control group,rated 35. 0% in the total. There was significant difference between two groups. No death occurred in both groups. [Conclusion] The treatment of cervical spondylosis with cervical disc replacement has a similar good effect when compared with fusion treatment,however,it significantly reduces the rate of degeneration of adjacent segments. So,it is worth popularizing in the clinical application.