CAJ | 학술논문

骨关节植入物%骨与关节循证医学%脊柱植入物%Bryan颈椎间盘置换%颈前路间盘切除植骨融合%颈椎总活动度%目测类比评分%颈部功能障碍指数%日本矫形外科协会评分%颈椎病%系统评价骨關節植入物%骨與關節循證醫學%脊柱植入物%Bryan頸椎間盤置換%頸前路間盤切除植骨融閤%頸椎總活動度%目測類比評分%頸部功能障礙指數%日本矯形外科協會評分%頸椎病%繫統評價
골관절식입물%골여관절순증의학%척주식입물%Bryan경추간반치환%경전로간반절제식골융합%경추총활동도%목측류비평분%경부공능장애지수%일본교형외과협회평분%경추병%계통평개

背景：Bryan颈椎间盘置换与颈前路间盘切除植骨融合治疗颈椎病的临床疗效存在争议。 　　目的：应用 Meta 分析方法，评价 Bryan 颈椎间盘置换与颈前路间盘切除植骨融合治疗颈椎病的临床疗效，为临床选择颈椎病的治疗方案提供依据。 　　方法：计算机检索Medline、PubMed 、EMBASE、OVID、中国生物医学数据库、万方数据库和中国知网数据库，手工检索中国主要7种骨科杂志，检索Bryan颈椎间盘置换与颈前路间盘切除植骨融合治疗颈椎病的临床研究。按照文中的纳入标准进行研究。提取颈椎总活动度、疼痛目测类比评分、颈部功能障碍指数、日本矫形外科协会评分等相关数据，利用RevMan4.2.2软件进行异质性和Meta分析，绘制森林图。 　　结果与结论：8篇文献符合纳入标准，共883例患者，其中Bryan颈椎间盘置换430例，颈前路间盘切除植骨融合453例。Meta分析发现在治疗后3个月和24个月，Bryan颈椎间盘置换组颈椎总活动度高于颈前路间盘切除植骨融合组；治疗后12个月2组差异无显著性意义。治疗后12个月和24个月2组疼痛目测类比评分、颈部功能障碍指数的差异无显著性意义。治疗后24个月2组日本矫形外科协会评分的差异无显著性意义。结果说明在治疗颈椎病时，在治疗后颈椎总活动度方面，Bryan 颈椎间盘置换优于颈前路间盘切除植骨融合，但2种治疗方案的神经减压效果无明显差异。
배경：Bryan경추간반치환여경전로간반절제식골융합치료경추병적림상료효존재쟁의。 　　목적：응용 Meta 분석방법，평개 Bryan 경추간반치환여경전로간반절제식골융합치료경추병적림상료효，위림상선택경추병적치료방안제공의거。 　　방법：계산궤검색Medline、PubMed 、EMBASE、OVID、중국생물의학수거고、만방수거고화중국지망수거고，수공검색중국주요7충골과잡지，검색Bryan경추간반치환여경전로간반절제식골융합치료경추병적림상연구。안조문중적납입표준진행연구。제취경추총활동도、동통목측류비평분、경부공능장애지수、일본교형외과협회평분등상관수거，이용RevMan4.2.2연건진행이질성화Meta분석，회제삼림도。 　　결과여결론：8편문헌부합납입표준，공883례환자，기중Bryan경추간반치환430례，경전로간반절제식골융합453례。Meta분석발현재치료후3개월화24개월，Bryan경추간반치환조경추총활동도고우경전로간반절제식골융합조；치료후12개월2조차이무현저성의의。치료후12개월화24개월2조동통목측류비평분、경부공능장애지수적차이무현저성의의。치료후24개월2조일본교형외과협회평분적차이무현저성의의。결과설명재치료경추병시，재치료후경추총활동도방면，Bryan 경추간반치환우우경전로간반절제식골융합，단2충치료방안적신경감압효과무명현차이。
BACKGROUND:Bryan cervical disc replacement and anterior cervical discectomy and fusion have a dispute in the treatment of cervical spondylosis. OBJECTIVE:To evaluate the clinical effects of Bryan cervical disc replacement and anterior cervical discectomy and fusion by meta-analysis, thereby providing clinical evidence for treatment strategy of cervical spondylosis. METHODS:The authors searched Medline, PubMed, EMBASE, OVID, CBM, CNKI and also searched manual y seven relevant Chinese orthopedic journals for articles pertinent to clinical research of Bryan cervical disc replacement and anterior cervical discectomy and fusion. Extracted data included the range of motion of the cervical spine, visual analog scale score, neck disability index, the Japanese Orthopaedic Association score. Meta-analysis and forest plots were conducted with RevMan4.2.2 Software. RESULTS AND CONCLUSION:There are eight articles in the meta-analysis, including 883 patients (430 patients receiving Bryan cervical disc replacement, and 453 patients receiving anterior cervical discectomy and fusion). Meta-analysis did detect statistical y significant differences in the range of motion of the cervical spine at 3 months and 24 months postoperatively between the two groups, but did not detect statistical y significant differences in visual analog scale score, neck disability index, the Japanese Orthopaedic Association score between the two groups. These findings indicate that Bryan cervical disc replacement is superior to anterior cervical discectomy and fusion in the range of motion of the cervical spine. However, the current literature offers no evidence to support superiority of the Bryan cervical disc replacement over the anterior cervical discectomy and fusion.