CAJ | 학술논문

目的：：评估15例Bryan人工颈椎间盘置换术治疗颈椎病的近期疗效，分析容易出现的并发症。方法：2011年1月至2013年10月，我院和镇江康复医疗集团医院、自治区中医院共同完成15例单节段Bryan人工颈椎间盘置换术，其中男6例，女9例；年龄33～57岁，平均45.2岁。脊髓型颈椎病7例，神经根型颈椎病6例，混合型2例。结果：全部病例随访6～18个月，平均随访13.2月。脊髓型颈椎病患者术前JOA评分为(8.5±1.0)分，末次随访时为(15.5±1.0)分，与术前比较有显著性差异(P＜0.01)。颈痛视觉评分（VAS）、颈肩障碍疼痛指数（NDI）与术前相比均具有统计学意义(P＜0.05)。神经根型颈椎病患者的症状完全消失。所有病例未见假体下沉、移位以及症状加重者。1例患者术后14个月随访时发现假体周围有异位骨化形成，2例术后置换节段出现颈椎曲度反曲后凸，随访后无明显改善。结论：Bryan人工颈椎间盘置换术治疗颈椎间盘疾患可取得良好的临床疗效，由于其手术操作较为复杂，并发症发生率较多，应重视手术适应证的选择和规范的手术操作。
목적：：평고15례Bryan인공경추간반치환술치료경추병적근기료효，분석용역출현적병발증。방법：2011년1월지2013년10월，아원화진강강복의료집단의원、자치구중의원공동완성15례단절단Bryan인공경추간반치환술，기중남6례，녀9례；년령33～57세，평균45.2세。척수형경추병7례，신경근형경추병6례，혼합형2례。결과：전부병례수방6～18개월，평균수방13.2월。척수형경추병환자술전JOA평분위(8.5±1.0)분，말차수방시위(15.5±1.0)분，여술전비교유현저성차이(P＜0.01)。경통시각평분（VAS）、경견장애동통지수（NDI）여술전상비균구유통계학의의(P＜0.05)。신경근형경추병환자적증상완전소실。소유병례미견가체하침、이위이급증상가중자。1례환자술후14개월수방시발현가체주위유이위골화형성，2례술후치환절단출현경추곡도반곡후철，수방후무명현개선。결론：Bryan인공경추간반치환술치료경추간반질환가취득량호적림상료효，유우기수술조작교위복잡，병발증발생솔교다，응중시수술괄응증적선택화규범적수술조작。
[ABSTRACT]Objective: Appraised 15 examples Bryan artificial neck intervertebral disc replaces the short-term curative effect which the technique treatment cervical vertebra gets sick, the complication which the analysis often appears. Methods: From January,2011 to October, 2013,my courtyard and Zhenjiang Recovery Medical service Group Hospital,the autonomous region Chinese medicine hospital together completes 15 example single stage Bryan artificial neck intervertebral disc to replace the technique, in which male 6 examples, female 9 examples;Age 33~57 year old, average 45.2 years old.The spinal cord cervical vertebra gets sick 7 examples,the nerve root cervical vertebra gets sick 6 examples, the mixed 2 examples. Results:All patients were followed up for 6~18 months, average 13.2 months follow-up. Spinal cord type of cervical spondylosis patients before JOA score (8.5±1)%, at last follow-up for (15.5±1),there was significant difference as compared with that before operation (P<0.01).Neck pain visual analogue scale (VAS), the neck shoulder disorders pain index (NDI) compared with the preoperative were statistically significant(P<0.05).Nerve root type cervical spondylosis symptoms completely disappeared. In all cases, no prosthesis subsidence, displacement and symptoms increase. In 1 patients after 14 months follow-up found around the prosthesis had heterotopic ossification,2 cases after replacement segment cervical curvature retrorsely kyphosis, no significant improvement of follow-up. Conclusion: Bryan artificial cervical disc replacement in the treatment of cervical disc disease can obtain good clinical curative effect, because the operation is complicated, the complication rate is more, should pay attention to the operation to operation operation certificate selection and specification.