摘要
目的总结采用一种新型人工颈椎间盘(Pretic-Ⅰ)行人工颈椎间盘置换术的早期疗效。方法回顾分析2014年6月—12月采用Pretic-Ⅰ人工椎间盘置换术治疗的10例单间隙颈椎间盘突出症患者临床资料。其中男4例,女6例;年龄27~51岁,平均40岁。病程4~36个月,平均15.4个月。手术节段:C_(4、5)1例,C_(5、6) 8例,C_(6、7) 1例。术前、术后即刻及术后3、6、12个月采用疼痛视觉模拟评分(VAS)、日本骨科协会(JOA)评分、颈椎功能障碍指数(NDI)评价疗效;于颈椎X线片测量目标椎间隙高度,目标椎间隙及上、下位相邻椎间隙活动度,评价颈椎运动功能。结果患者均顺利完成手术并获随访12个月。随访期间未出现神经症状加重、椎动脉损伤、食管气管瘘、脑脊液漏、切口感染、血肿形成、假体松动、脱落等并发症。术后各时间点VAS评分、JOA评分及NDI均较术前显著改善(P<0.05)。术后即刻及3个月时目标椎间隙高度显著高于术前(P<0.05);术后6、12个月与术前比较差异无统计学意义(P>0.05)。术后各时间点目标椎间隙及上、下位相邻椎间隙活动度与术前比较差异均无统计学意义(P>0.05)。结论 Pretic-Ⅰ人工颈椎间盘置换术治疗单间隙颈椎间盘突出症早期疗效良好,临床症状改善明显,同时较好地维持了手术节段及上、下相邻间隙的运动特征。
Objective To observe the early effectiveness of cervical disc replacement with Pretic-I, a new type artificial disc. Methods A retrospective analysis was made on the clinical data of 10 patients who underwent single segmental cervical disc replacement with Pretic-I from June to December 2014. Among 10 patients, 4 were male and 6 were female, with an average age of 40 years （range, 27-51 years）. The mean disease duration was 15.4 months （range, 4-36 months）. Affected segments located at C4, 5 level in 1 case, at C5, 6 level in 8 cases, and at C6, 7 level in 1 case. The visual analogue scale （VAS）, Japanese Orthopaedic Association （JOA） score, and neck disability index （NDI） were used to evaluate the clinical outcomes. Besides, the disc height and the range of motion （ROM） at operated level, and ROM of upper and lower adjacent level were measured to assess the function. Results The operation was successfully completed in all patients who were followed up for 12 months. No complications of aggravated nerve symptoms, vertebral artery injury, esophagotracheal fistula, cerebrospinal fluid leakage, incision infection, hematoma and prosthetic loosening were observed during follow-up. The VAS score, JOA score, and NDI significantly improved at each time point after operation when compared with preoperative scores （P〈0.05）. The height of intervertebral disc at operated level was significantly increased at immediate and 3 months after operation when compared with preoperative one （P〈0.05）, but no significant difference was found between at 6 months or 12 months after operation and at pre-operation （P〉0.05）. No significant difference was shown in the ROM at operated level, and ROM of upper and lower adjacent level between at pre-operation and at each time point after operation （P〉0.05）. Conclusion The early effctiveness of cervical disc replacement using Pretic-I is satisfactory. The symptoms can be relieved significantly and the dynamic features of the operated level, as well as the upper and lower adjacent levels, are well preserved.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2017年第5期513-518,共6页
Chinese Journal of Reparative and Reconstructive Surgery
