人工颈椎间盘置换术的临床疗效研究进展

A review on the clinical advances of artificial cervical disc replacement

颈椎间盘疾病是临床常见病、多发病，随着对其治疗的不断进步，对颈椎椎体间的稳定性及活动度提出了双重要求，非融合术式治疗颈椎间盘疾病逐步引起人们的重视。人工颈椎间盘置换术（ artificial cervical disc replacement，ACDR ）作为一种非融合术式，既去除了退变椎间盘的压迫，又可以保留颈椎的节段活动度，在一定程度上防止邻近节段退变（ adjacent segment degeneration， ASDeg ），多个国内外临床中心研究报道其在保持颈椎活动度及防止 ASDeg 方面达到了预期目的[1-2]。但人工椎间盘价格昂贵，置换后引起异位骨化、自发融合、手术节段再手术等问题也引起一定程度上对其疗效的质疑。随着随访时间的延长，中、长期疗效得到越来越多的报道，对其临床疗效的认识也更加客观、全面。笔者总结最新的文献，对人工椎间盘置换术的疗效，特别是其中、长期疗效进行综述如下。

Anterior cervical discectomy and fusion （ ACDF ） is one of the commonest operative methods in the treatment of cervical intervertebral disc diseases. It needs to remove the degenerated disc and ifx the upper and lower vertebral bodies together, but in this way, the disc loses the motion and the stress of the adjacent segments might increase. Therefore, non-fusion method begins to attract extensive attention in clinical practice. Artiifcial cervical disc replacement is a new operation, which has become popular gradually in recent years and its short term clinical outcomes are reported to be satisfactory. However, whether it can really sustain the range of motion persistently and decrease the degeneration of the adjacent segments is unknown. It is still controversial whether its clinical outcomes are better than ACDF. All of these problems need to be proved by mid-long term clinical efifcacy. In this paper, we summarize the clinical efifcacy and application prospect of artiifcial cervical disc replacement based on the latest literature.