CAJ | 학술논문

背景：人工颈椎间盘假体模拟正常椎间盘的活动度和缓冲震荡功能，在临床前期实验证明人工颈椎间盘假体材料具有良好的生物相容性和力学特点。目的：2年随访评价人工颈椎间盘置换与零切迹椎间融合内固定系统置入治疗多节段颈椎病。方法：应用人工颈椎间盘置换联合零切迹椎间融合内固定系统置入治疗多节段颈椎病患者42例，患者均存在脊髓或神经根受压的典型症状及体征，脊髓型颈椎病18例，神经根型颈椎病15例，混合型颈椎病10例，治疗后测定平均手术时间、出血量和再手术率，观察治疗后并发症，颈部功能残障指数，目测类比评分及颈椎相应手术节段功能单位范围，C2-C7椎体Cobb 角、病变椎体近端及远端临近节段活动度，评价临床疗效。结果与结论：所有病例均顺利完成手术和各时间点的评分，治疗后患者颈肩部及上肢放射痛明显缓解，麻木、感觉减退症状消失显著，生活质量明显提高。末次随访目测类比评分及颈部功能残障指数评分均较治疗前有所降低，差异有显著性意义(P <0.001)，C2-C7椎体Cobb 角、FSU 角、手术相邻节段近端活动度和手术相邻节段远端活动度较治疗前有所提高，差异均有显著性意义(P <0.001)，提示经治疗后颈椎病症状有所改善，人工颈椎间盘置换联合零切迹椎间融合内固定系统置入后颈椎病的各项指标均得到不同程度的重建。
배경：인공경추간반가체모의정상추간반적활동도화완충진탕공능，재림상전기실험증명인공경추간반가체재료구유량호적생물상용성화역학특점。목적：2년수방평개인공경추간반치환여령절적추간융합내고정계통치입치료다절단경추병。방법：응용인공경추간반치환연합령절적추간융합내고정계통치입치료다절단경추병환자42례，환자균존재척수혹신경근수압적전형증상급체정，척수형경추병18례，신경근형경추병15례，혼합형경추병10례，치료후측정평균수술시간、출혈량화재수술솔，관찰치료후병발증，경부공능잔장지수，목측류비평분급경추상응수술절단공능단위범위，C2-C7추체Cobb 각、병변추체근단급원단림근절단활동도，평개림상료효。결과여결론：소유병례균순리완성수술화각시간점적평분，치료후환자경견부급상지방사통명현완해，마목、감각감퇴증상소실현저，생활질량명현제고。말차수방목측류비평분급경부공능잔장지수평분균교치료전유소강저，차이유현저성의의(P <0.001)，C2-C7추체Cobb 각、FSU 각、수술상린절단근단활동도화수술상린절단원단활동도교치료전유소제고，차이균유현저성의의(P <0.001)，제시경치료후경추병증상유소개선，인공경추간반치환연합령절적추간융합내고정계통치입후경추병적각항지표균득도불동정도적중건。
BACKGROUND:Artificial cervical disc prosthesis simulates range of motion and buffer shock function of normal intervertebral discs. Clinical experiments verify that artificial cervical disc prosthesis material has good biocompatibility and mechanical characteristics. OBJECTIVE:To evaluate artificial cervical disc replacement and zero-profile interbody fixation and fusion system for multilevel cervical disease in 2-year folow-up. METHODS:Artificial cervical disc replacement and zero-profile interbody fixation and fusion system were used to treat 42 patients with multilevel cervical disease. The patient presented typical symptoms and signs of spinal cord or nerve root compression. There were 18 cases of cervical myelopathy, 15 cases of nerve root cervical spondylosis and 10 cases of mixed type of cervical spondylosis. After treatment, mean operation time, blood loss and reoperation rate were measured. Postoperative complications, disability index of neck function, visual analog scale, function unit range of corresponding surgery segments of the cervical spine, Cobb angle of C2-C7 vertebral body, range of motion of adjacent segment of proximal and distal vertebral bodies were observed and clinical outcomes were evaluated. RESULTS AND CONCLUSION: Al cases finished the operation and were scored at various time points. After treatment, radiating pain of shoulder and neck and upper extremity were remarkably lessened. Numbness and sensory loss symptoms disappeared obviously. Quality of life elevated noticeably. Visual analog scale and the disability index of neck function score were decreased in final folow-up compared with pre-treatment (P < 0.001). C2-C7 vertebrae Cobb angle, FSU angle, range of motion of proximal surgery adjacent segment and range of motion of the distal surgery adjacent segment were elevated compared with pre-treatment (P < 0.001). These data indicate that cervical spondylosis was improved after treatment. Each index of cervical spondylosis after artificial cervical disc replacement and zero-profile interbody fixation and fusion system was reconstructed to different degrees.