单节段Activ-C与Bryan颈椎人工椎间盘置换治疗颈椎病临床效果比较

Comparison of clinical effects of single-level cervical disc replacement by Activ-C versus Bryan artificial disc in the treatment of cervical spondylosis

目的比较单节段Activ-C与Bryan颈椎人工椎间盘置换治疗颈椎病的临床效果差异。方法回顾性分析郑州市骨科医院2009年6月至2012年6月采用人工椎间盘置换手术治疗的51例颈椎病患者的临床资料。根据术式不同将患者分为两组,其中Activ-C组(28例)行Activ-C颈椎人工椎间盘置换,Bryan组(23例)行Bryan颈椎人工椎间盘置换。记录两组患者术前及术后末次随访时日本骨科学会(JOA)评分、视觉模拟量表(VAS)评分、颈椎整体侧屈活动度、手术节段前后屈伸活动度等指标并进行比较。结果随访时间6~16个月,平均随访时间6.9个月。末次随访时,两组患者JOA、VAS评分均较术前明显改善,但两组改善值比较,差异无统计学意义(P>0.05);Activ-C组患者颈椎整体侧屈活动度及手术节段前后屈伸活动度均大于Bryan组,两组比较,差异有统计学意义(P<0.05)。结论近期随访结果提示,Activ-C与Bryan人工椎间盘置换在改善颈椎病患者疼痛症状及恢复神经功能等方面疗效相当,但前者可保留更大的颈椎侧屈活动度和前后屈伸活动度,其远期结果尚需进一步深入研究。

Objective To compare the clinical effects between single-segment Activ-C and Bryan cervical artificial disc replacement(CADR)in the treatment of cervical spondylosis.Methods Clinical data of 51 patients with cervical spondylosis treated by CADR from June 2009 to June 2012 in Zhengzhou Orthopaedic Hospital were analyzed retrospectively.Among them,28 patients were treated with Activ-C artificial disc(Activ-C group),and 23 patients with Bryan artificial disc(Bryan group).Before the surgery and at the last follow-up,Japanese Orthopaedic Association(JOA)score,visual analogue scale(VAS)score,range of motion(ROM)in cervical vertebral lateral flexion,and flexion-extension ROM at the operative segment were recorded,and the differences between two groups were compared.Results All patients were followed up with the average time of 6.9 months(6 to 16 months).At the last follow-up,JOA and VAS scores all improved compared with the preoperative ones in two groups,but there was no significant difference of the improvement value of JOA score or VAS score between two groups(P>0.05);Compared with the Bryan group,the overall cervical vertebral lateral flexion ROM and flexion-extension ROM at the operative segment in Activ-C group were better,the differences were statistically significant(P<0.05).Conclusions Short-term results showed that Activ-C and Bryan artificial disc replacement for the treatment of cervical spondylosis could obtain similar clinical effects for improving patients'neurological function and relieving pain,but Activ-C artificial discs might retain greater cervical lateral flexion ROM and flexion-extension ROM;Long-term results should be further observed.