目的 評估單節(jié)段Bryan 人工頸椎間盤置換術(shù)后異位骨化發(fā)生情況,分析異位骨化對術(shù)后療效影響。 方法 回顧分析2005 年10 月- 2007 年10 月48 例行單節(jié)段Bryan 人工頸椎間盤置換術(shù)患者臨床資料。男27 例,女21 例;年齡33 ~ 51 歲,平均40.5 歲。脊髓型頸椎病8 例,神經(jīng)根型頸椎病27 例,混合型頸椎病13 例。病程2 ~ 14個(gè)月,平均10.3 個(gè)月。病變節(jié)段:C3、4 3 例,C4、5 6 例,C5、6 30 例,C6、7 9 例。術(shù)后采用疼痛視覺模擬評分(VAS)、頸椎功能障礙指數(shù)(NDI)、置換節(jié)段活動(dòng)度評價(jià)療效;并將患者按術(shù)后是否發(fā)生異位骨化分為兩組,比較術(shù)后1、2、3、4 年以上各指標(biāo)差異。 結(jié)果 患者術(shù)中及術(shù)后均無嚴(yán)重并發(fā)癥發(fā)生。48 例均獲隨訪,隨訪時(shí)間48 ~ 72 個(gè)月,平均56.6 個(gè)月。術(shù)后各時(shí)間點(diǎn)VAS 評分及NDI 均較術(shù)前顯著改善(P lt; 0.05);除術(shù)后3 d,其余各時(shí)間點(diǎn)置換節(jié)段活動(dòng)度與術(shù)前比較差異均無統(tǒng)計(jì)學(xué)意義(P gt; 0.05)。術(shù)后4 年共13 例(27.08%)發(fā)生異位骨化,其中1 級8 例,2 級3 例,3 級2 例。異位骨化組和無異位骨化組患者術(shù)后各時(shí)間點(diǎn)置換節(jié)段活動(dòng)度及VAS 評分、NDI 比較,差異均無統(tǒng)計(jì)學(xué)意義(P gt; 0.05)。 結(jié)論 單節(jié)段Bryan 人工頸椎間盤置換術(shù)后異位骨化發(fā)生率相對較高,異位骨化對人工頸椎間盤置換節(jié)段活動(dòng)度影響較小,對術(shù)后療效無明顯影響。
引用本文: 劉文華,朱兵,劉曉偉,孫宇. 單節(jié)段Bryan 人工頸椎間盤置換術(shù)后異位骨化的發(fā)生率和療效觀察. 中國修復(fù)重建外科雜志, 2012, 26(6): 699-702. doi: 復(fù)制
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3. | Bertagnoli R, Duggal N, Pickett GE, et al. Cervical total disc replacement, part two: clinical results. Orthop Clin North Am, 2005, 36(3): 355-362. |
4. | Porchet F, Metcalf NH. Clinical outcomes with the Prestige II cervical disc: preliminary results from a prospective randomized clinical trial. Neurosurg Focus, 2004, 17(3): E6. |
5. | Toyoda T, Matsumoto H, Tsuji T, et al. Heterotopic ossification after total knee arthroplasty. J Arthroplasty, 2003, 18(8): 760-764. |
6. | McAfee PC, Cunningham BW, Devine J, et al. Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech, 2003, 16(4): 384-389. |
7. | Mehren C, Suchomel P, Grochulla F, et al. Heterotopic ossification in total cervical artificial disc replacement. Spine (Phila Pa 1976), 2006, 31(24): 2802-2806. |
8. | 劉忠軍. 脊柱外科手術(shù)操作與技術(shù). 北京: 人民衛(wèi)生出版社, 2009: 26-27. |
9. | 周非非, 趙衍斌, 孫宇, 等. Bryan人工頸椎間盤置換術(shù)后異位骨化形成的臨床因素分析. 中國脊柱脊髓雜志, 2009, 19(1): 39-43. |
10. | Goffin J, van Calenbergh F, van Loon J, et al. Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level. Spine (Phila Pa 1976), 2003, 28(24): 2673-2678. |
11. | Wigfield C, Gill S, Nelson R, et al. Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease. J Neurosurg, 2002, 96(1 Suppl): 17-21. |
12. | 田偉, 劉波, 李勤, 等. Bryan人工頸椎間盤置換對頸椎功能影響的臨床分析. 中華外科雜志, 2008, 46(5): 338-341. |
13. | 楊大龍, 申勇, 曹俊明, 等. 頸人工椎間盤置換近期并發(fā)癥分析. 中國脊柱脊髓雜志, 2008, 18(4): 249-252. |
14. | Leung C, Casey AT, Goffin J, et al. Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery, 2005, 57(6): 759-763. |
15. | 孫宇, 潘勝發(fā), 張鳳山, 等. Bryan人工椎間盤置換術(shù)治療頸椎病的近期臨床效果及出現(xiàn)的問題. 中國脊柱脊髓雜志, 2008, 18(1): 13-17. |
16. | Botelho RV, Moraes OJ, Fernandes GA, et al. A systematic review of randomized trials on the effect of cervical disc arthroplasty on reducing adjacent-level degeneration. Neurosurg Focus, 2010, 28(6): E5. |
17. | Lee JH, Jung TG, Kim HS, et al. Analysis of the incidence and clinical effect of the heterotopic ossification in a single-level cervical artificial disc replacement. Spine J, 2010, 10(8): 676-682. |
18. | Kim SW, Limson MA, Kim SB, et al. Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J, 2009, 18(2): 218-231. |
19. | Du J, Li M, Liu H, et al. Early follow-up outcomes after treatment of degenerative disc disease with the discover cervical disc prosthesis. Spine J, 2011, 11(4): 281-289. |
20. | Sasso RC, Snmcker JD, Haeker RJ, et al. Artificial disc versus fusion: a prospective, randomized study with 2-year follow-up on 99 patients. Spine (Phila Pa 1976), 2007, 32(26): 2933-2942.. |
21. | Kim SW, Paik SH, Castro PA, et al. Analysis of factors that may influence range of motion after cervical disc arthroplasty. Spine J, 2010, 10(8): 683-688. |
22. | Zechmeister I, Winkler R, Mad P. Artifi cial total disc replacement versusfusion for the cervical spine: a systematic review. Eur Spine J, 2011, 20(2): 177-184. |
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- 2.
- 3. Bertagnoli R, Duggal N, Pickett GE, et al. Cervical total disc replacement, part two: clinical results. Orthop Clin North Am, 2005, 36(3): 355-362.
- 4. Porchet F, Metcalf NH. Clinical outcomes with the Prestige II cervical disc: preliminary results from a prospective randomized clinical trial. Neurosurg Focus, 2004, 17(3): E6.
- 5. Toyoda T, Matsumoto H, Tsuji T, et al. Heterotopic ossification after total knee arthroplasty. J Arthroplasty, 2003, 18(8): 760-764.
- 6. McAfee PC, Cunningham BW, Devine J, et al. Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech, 2003, 16(4): 384-389.
- 7. Mehren C, Suchomel P, Grochulla F, et al. Heterotopic ossification in total cervical artificial disc replacement. Spine (Phila Pa 1976), 2006, 31(24): 2802-2806.
- 8. 劉忠軍. 脊柱外科手術(shù)操作與技術(shù). 北京: 人民衛(wèi)生出版社, 2009: 26-27.
- 9. 周非非, 趙衍斌, 孫宇, 等. Bryan人工頸椎間盤置換術(shù)后異位骨化形成的臨床因素分析. 中國脊柱脊髓雜志, 2009, 19(1): 39-43.
- 10. Goffin J, van Calenbergh F, van Loon J, et al. Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level. Spine (Phila Pa 1976), 2003, 28(24): 2673-2678.
- 11. Wigfield C, Gill S, Nelson R, et al. Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease. J Neurosurg, 2002, 96(1 Suppl): 17-21.
- 12. 田偉, 劉波, 李勤, 等. Bryan人工頸椎間盤置換對頸椎功能影響的臨床分析. 中華外科雜志, 2008, 46(5): 338-341.
- 13. 楊大龍, 申勇, 曹俊明, 等. 頸人工椎間盤置換近期并發(fā)癥分析. 中國脊柱脊髓雜志, 2008, 18(4): 249-252.
- 14. Leung C, Casey AT, Goffin J, et al. Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery, 2005, 57(6): 759-763.
- 15. 孫宇, 潘勝發(fā), 張鳳山, 等. Bryan人工椎間盤置換術(shù)治療頸椎病的近期臨床效果及出現(xiàn)的問題. 中國脊柱脊髓雜志, 2008, 18(1): 13-17.
- 16. Botelho RV, Moraes OJ, Fernandes GA, et al. A systematic review of randomized trials on the effect of cervical disc arthroplasty on reducing adjacent-level degeneration. Neurosurg Focus, 2010, 28(6): E5.
- 17. Lee JH, Jung TG, Kim HS, et al. Analysis of the incidence and clinical effect of the heterotopic ossification in a single-level cervical artificial disc replacement. Spine J, 2010, 10(8): 676-682.
- 18. Kim SW, Limson MA, Kim SB, et al. Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J, 2009, 18(2): 218-231.
- 19. Du J, Li M, Liu H, et al. Early follow-up outcomes after treatment of degenerative disc disease with the discover cervical disc prosthesis. Spine J, 2011, 11(4): 281-289.
- 20. Sasso RC, Snmcker JD, Haeker RJ, et al. Artificial disc versus fusion: a prospective, randomized study with 2-year follow-up on 99 patients. Spine (Phila Pa 1976), 2007, 32(26): 2933-2942..
- 21. Kim SW, Paik SH, Castro PA, et al. Analysis of factors that may influence range of motion after cervical disc arthroplasty. Spine J, 2010, 10(8): 683-688.
- 22. Zechmeister I, Winkler R, Mad P. Artifi cial total disc replacement versusfusion for the cervical spine: a systematic review. Eur Spine J, 2011, 20(2): 177-184.