摘要
目的探讨应用颈椎动态稳定器（dynamic cervical implant，DCI）治疗颈椎间盘突出症的安全性及早期临床疗效。方法2009年9月至2010年12月，应用颈前路DCI治疗31例颈椎间盘突出症患者，记录并统计分析手术时间和出血量；采用颈椎残障功能指数（neck disability index，NDI）、日本矫形外科协会（Japanese Orthopaedic Association，JOA）评分评价神经功能改善情况，评估患者手术前后的疼痛视觉模拟评分（visual analogue scale，VAS）。在x线片上测量术前和末次随访时植人节段的运动范围、手术节段脊柱功能单位（functionalspineunit，FSU）高度与上位椎体高度比值（H／h）等的差异。结果31例患者的手术时间为（45-15）min，出血量为（100-30）ml。术后随访6-20个月，平均14个月。术前与末次随访时植入节段的运动范围（9．6°±4．2°VS．6．9°±5．3°，P〉0．05）、H／h（2．6±0．1vs2．5±0．1，P〉O．05）和FSU的角度（2．6°±5．2°VS．1．7°±2．9°，P〉0．05）差异无统计学意义；而术前与末次随访时NDI（50．5±16．2 vs 19．6±4．3，P〈0．05）、JOA评分（12．3±1．6 vs 13．9±1．8，P〈0．05）及颈痛VAS（6．3±2．6vs3．1±2．2，P〈0．05）差异有统计学意义。结论应用DCI非融合技术治疗颈椎间盘突出症，手术时间短，出血少，可以早期保留手术节段的运动功能，维持了椎间高度，早期临床效果满意。
Objective To investigate the safety and early chnical efficiency of dynamic cervical implant （DCI） internal fixation to treat cervical disc herniation. Methods From September 2009 to December 2010, 31 patients with herniation of cervical disc underwent DCI implantation. The operation time and blood loss were recorded and analyzed. Neck disability index （NDI）, Japanese Orthopaedic Association （JOA） score, and visual analogue scale （VAS） score were used to evaluate neurofunctional recovery pre- and post-opera- tion. Routinely, the patients accepted X-ray examination preoperatively and postoperatively. We used White＇s measurement to measure the range of motion（ROM） and height ratio of implant segment and the su- perior vertebra pre- and post-operation. Results The average operation time and amount of bleeding were 45 （30-60） tin and （100±30） ml respectively. The average postoperative follow-up was 14 months （range, 6- 20）. The average NDI （50.5±16.2 vs. 19.6±4.3, P〈0.05）, JOA score （12.3±1.6 vs. 13.9±1.8, P〈0.05） and VAS score （6.3±2.6 vs. 3.1±2.2, P〈O.05） changed significantly at the last follow-up compared with those pre-oper- ation. There were no significant differences in the average ROM of implant segment （9.6°±4.2° vs. 6.90±5.3, P〉0.05）, the height ratio of implant segment and the superior vertebra （2.6±0.1 vs. 2.5±0.1, P〉0.05） and the angle of functional spine unit （2.6°±5.2° vs. 1.7°±2.9°, P〉0.05） at last follow-up compared with those preoperation. Conclusion Using DCI to treat cervical disc herniation had shorter operation time and less bleeding advantages, and the early clinical effect was satisfactory. It may retain the cervical biomechanical movement in some degree, maintain the cervical stability.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2012年第1期26-31,共6页
Chinese Journal of Orthopaedics
关键词
颈椎
椎间盘移位
假体和植入物
治疗结果
Cervical vertebrae
Intervertebral disk displacement
Prostheses and implants
Treatment outcome
