CAJ | 학술논문

目的对比总结多节段颈椎间盘突出症患者分别实施人工椎间盘置换和颈前路融合固定的效果分析,判断人工椎间盘置换术后效果.方法自2005年7月对16例多节段颈椎间盘突出患者进行了前路椎间盘切除、Bryan人工椎间盘置换术(A组),观察手术前后VAS评分及颈椎活动度变化,并与同期所做的多节段颈前路融合内固定23例患者(B组)相对照.结果两组患者术后各时间点疼痛缓解、VAS评分较术前有明显提高(P＜0.05),术后两组VAS评分比较差异未见统计学意义(P＞0.05).术后12个月及2年时两组间整体活动度比较差异有统计学意义(P＜0.05),A组人工椎间盘置换节段术后2年活动度与术前比较差异未见统计学意义(P＞0.05).A组末次随访时较术后3d时显著增加(P＜0.05);B组术后各时间点比较差异未见统计学意义(P＞0.05).结论人工椎间盘置换治疗多节段颈椎间盘突出症临床效果较好,术后对手术节段的活动度影响较小,是一种解决颈椎活动性与稳定性矛盾的较好的方法.
목적 대비총결다절단경추간반돌출증환자분별실시인공추간반치환화경전로융합고정적효과분석,판단인공추간반치환술후효과.방법 자2005년7월대16례다절단경추간반돌출환자진행료전로추간반절제、Bryan인공추간반치환술(A조),관찰수술전후VAS평분급경추활동도변화,병여동기소주적다절단경전로융합내고정23례환자(B조)상대조.결과 량조환자술후각시간점동통완해、VAS평분교술전유명현제고(P＜0.05),술후량조VAS평분비교차이미견통계학의의(P＞0.05).술후12개월급2년시량조간정체활동도비교차이유통계학의의(P＜0.05),A조인공추간반치환절단술후2년활동도여술전비교차이미견통계학의의(P＞0.05).A조말차수방시교술후3d시현저증가(P＜0.05);B조술후각시간점비교차이미견통계학의의(P＞0.05).결론 인공추간반치환치료다절단경추간반돌출증림상효과교호,술후대수술절단적활동도영향교소,시일충해결경추활동성여은정성모순적교호적방법.
Objective To evaluate the therapeutic effects of the multi-level cervical artificial disc replacements compared with the anterial cervical artificial fusion on the multi-level disc fusion and to investigate their effect after the treatment.Methods The patient with discectomy underwent cervical artificial disc replacements (group A) in the C3-7 intervertebral discs from July.2005.The VAS score and the range of motion(ROM) of two groups was observed perioperatively.Results The patient could move his neck in all directions without pain.The spinal and neural symptoms were significantly alleviated,and there were obviously elevation in VAS score in each time point (P ＜ 0.05),and there was no significant difference in VAS score between the two groups (P ＜ 0.05).There were significant differences in the range of motion(ROM) of two groups according to the follow-up for 12 month and 2 years,ROM was close to preoperative level in group A,and according to the last follow-up,there were significant increase to compare with postoperatively 3 days,but there was no significant difference in group B on every time point.Conclusions Artificial disc replacement compared with muti-segment fusion is a new way to treat multi-level disc herniations surgically,with good clinical results,and there were little effect on the range of motion.So artificial disc replacement is an effective way to deal with the contradiction of motion and immobilization.