| 王贝宇,刘浩,丁琛,胡韬,石锐,李涛,洪瑛,宋跃明,刘立岷,曾建成,孔清泉.Bryan人工颈椎椎间盘置换术治疗颈椎病的中期临床效果及对邻近椎间盘退变的影响[J].脊柱外科杂志,2011,9(5):273-278. |
Bryan人工颈椎椎间盘置换术治疗颈椎病的中期临床效果及对邻近椎间盘退变的影响  点此下载全文 (Fulltext) |
| 王贝宇 刘浩 丁琛 胡韬 石锐 李涛 洪瑛 宋跃明 刘立岷 曾建成 孔清泉 |
| 610041 四川, 四川大学华西医院骨科;610041 四川, 四川大学华西医院骨科;610041 四川, 四川大学华西医院骨科;610041 四川, 四川大学华西医院骨科;610041 四川, 四川大学华西医院骨科;610041 四川, 四川大学华西医院骨科;四川大学华西医院手术室;610041 四川, 四川大学华西医院骨科;610041 四川, 四川大学华西医院骨科;610041 四川, 四川大学华西医院骨科;610041 四川, 四川大学华西医院骨科 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2011.05.005 |
| 摘要点击次数: 1033 |
| 全文下载次数: 959 |
| 摘要： |
| 目的 观察Bryan人工颈椎椎间盘置换术治疗颈椎病的中期临床效果，研究该术对邻近椎间盘的影响。方法 2004年11月~2007年12月间，对34例颈椎间盘突出症患者共38个节段实施Bryan人工颈椎椎间盘置换术，于术前及术后1周、3个月、6个月、12个月、24个月、36个月、48个月、60个月进行SF-36、颈椎功能障碍指数（neck disabrlity index，NDI）、疼痛视觉模拟量表（visual anatague scale，VAS）评分及Odom标准评定临床效果；于术前、术后12月、24月、36月、48月、60月，用X线椎间盘退变评分系统（0-9分法）评估该手术对邻近椎间盘的影响；记录并发症及再手术的发生情况。结果 Bryan人工颈椎椎间盘置换术后患者症状较术前改善明显，短期临床效果显著。术后36个月和48个月依然保持良好的中期临床效果，中期随访中可见临床效果稍有下降，但末次随访仍保持良好的临床效果。手术未导致椎间盘退变加剧，无严重退行性变发生。无严重并发症及再手术。结论 Bryan人工颈椎椎间盘治疗颈椎病的中期临床效果良好，未导致邻近椎间盘退变加剧。 |
| 关键词：颈椎 椎间盘 人工关节 关节成形术, 置换 |
| Mid-term clinical outcome of Bryan artificial cervical disc replacement for cervical spondylosis and its effect on degeneration of adjacent discs Fulltext |
| WANG Bei-yu LIU Hao DING Chen HU Tao SHI Rui LI Tao HONG Ying SONG Yue-ming LIU Li-min ZENG Jian-cheng KONG Qing-quan |
| Department of Orthopaedics, West China Hospital, Sichua University, Chengdu 610041, Sichuan, China;Department of Orthopaedics, West China Hospital, Sichua University, Chengdu 610041, Sichuan, China;Department of Orthopaedics, West China Hospital, Sichua University, Chengdu 610041, Sichuan, China;Department of Orthopaedics, West China Hospital, Sichua University, Chengdu 610041, Sichuan, China;Department of Orthopaedics, West China Hospital, Sichua University, Chengdu 610041, Sichuan, China;Department of Orthopaedics, West China Hospital, Sichua University, Chengdu 610041, Sichuan, China;Department of Orthopaedics, West China Hospital, Sichua University, Chengdu 610041, Sichuan, China;Department of Orthopaedics, West China Hospital, Sichua University, Chengdu 610041, Sichuan, China;Department of Orthopaedics, West China Hospital, Sichua University, Chengdu 610041, Sichuan, China;Department of Orthopaedics, West China Hospital, Sichua University, Chengdu 610041, Sichuan, China |
| Fund Project: |
| Abstract: |
| Objective To observe the clinical outcome of Bryan artificial cervical disc replacement for cervical spondylosis, and to investigate its effect on degeneration of adjacent discs in mid-term study. Methods From November 2004 to December 2007, 34 patients (38 discs) receiving Bryan artificial cervical disc replacement were included in this study. Clinical results were evaluated by SF-36 score, neck disabrlity index (NDI) score, neck/arm pain visual anatague scale (VAS) scores and Odom's scale. The data were collected before surgery and at 1 week, 3, 6, 12, 24, 36, 48 and 60 months after surgery. Adjacent degeneration was assessed by scoring system of cervical disk degeneration based on neutral lateral radiographs before operation and 12, 24, 36, 48 and 60 months after surgery. Incidence of postoperative complications and reoperations were also recorded. Results The neurological symptoms of each patient were significantly alleviated in short term after operation. The postoperative SF-36 physical component score and SF-36 mental component score, NDI score and neck/arm pain VAS scores were significantly improved compared with those of pre-operation. In 36 and 48 months after surgey, excellent and good outcomes were observed, though there were some cases with decreased outcomes; sound outcomes were achieved at the final follow-up in all cases. Mild degeneration of adjacent discs occurred after operation, but there was no severe degeneration at the final follow-up. There was no prosthesis subsidence or excursion, no heterotopic ossification or spontaneous fusion, and no reoperation. Conclusion Bryan artificial disc replacement has a sound clinical outcome in mid-term and can protect against acceleration of adjacent discs degeneration. |
| Keywords:Cervical vertebrae Intervertebral disk Joint prosthesis Arthroplasty, replacement |
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