CAJ | 학술논문

目的对照人工椎间盘置换术与脊柱融合术治疗颈椎病的临床效果.方法对2007年1月至2008年12月共20例颈椎病患者施行人工椎间盘置换术(人工椎间盘置换组),对24例颈椎病患者实施脊柱融合术(脊椎融合组).手术前和术后3个月对2种手术方式疗效进行日本骨科协会(JOA)评分,并分别摄颈椎动力位X线片,观察颈椎的稳定性及活动度,比较2种手术效果.结果 2种手术方法术后临床症状缓解,脊髓功能改善,均无并发症.术后3个月,所有患者JOA评分均较术前明显提高(13.3±1.9 vs 9.2±2.2;12.5±2.1 vs 8.8±2.3,P<0.01),2种手术方法间比较,JOA评分无统计学意义(13.3±1.9 VS 12.5±2.1,P>0.05).结论人工椎间盘置换术治疗颈椎病的临床效果与脊柱融合术相同,但人工椎间盘置换术具有脊柱稳定性良好,运动功能无明显丢失,手术及临近节段的活动范围接近正常人群等优点,因此有利于预防脊柱邻近节段继发性退变.
목적 대조인공추간반치환술여척주융합술치료경추병적림상효과.방법 대2007년1월지2008년12월공20례경추병환자시행인공추간반치환술(인공추간반치환조),대24례경추병환자실시척주융합술(척추융합조).수술전화술후3개월대2충수술방식료효진행일본골과협회(JOA)평분,병분별섭경추동력위X선편,관찰경추적은정성급활동도,비교2충수술효과.결과 2충수술방법술후림상증상완해,척수공능개선,균무병발증.술후3개월,소유환자JOA평분균교술전명현제고(13.3±1.9 vs 9.2±2.2;12.5±2.1 vs 8.8±2.3,P<0.01),2충수술방법간비교,JOA평분무통계학의의(13.3±1.9 VS 12.5±2.1,P>0.05).결론 인공추간반치환술치료경추병적림상효과여척주융합술상동,단인공추간반치환술구유척주은정성량호,운동공능무명현주실,수술급림근절단적활동범위접근정상인군등우점,인차유리우예방척주린근절단계발성퇴변.
Objectives To compare the curative effects of artificial disc replacement and spinal fusion in treating cervical spondylosis. Methods A total of 20 patients with cervical spondylosis received artificial disc re-placement and 24 cases were treated with spinal fusion. Japanese Orthopedic Association(JOA) 17 score scale was used for the neurological assessment and dynamical X-rays examination was done preoperatively and 3 month postop-eratively. The stability and the movement range of the cervical vertebrae were observed. Results All patients in two groups had improvement of clinical symptom and spinal cord function. There was no complication. Three months later, JOA score increased obviously in all cases(P <0.01) and there was no statistical significance between two groups (P>0.05). Conclusions Artificial disc replacement and the spinal fusion show the same clinical results in treating cervical spondylosis, but the artificial disc replacement has advantages like good spinal stability, no loss of motor function, motion range of close to normal population and helps prevent adjacent degeneration.