Mobi-C颈人工间盘与MC+颈椎间融合器治疗颈椎病的病例对照研究
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作者Author单位AddressE-Mail
李思维 LI Si-wei 鞍钢集团公司总医院骨科, 辽宁 鞍山 114003 Department of Orthopaedics, Anshan Iron and Steel Group General Hospital, Anshan 114003, Liaoning, China  
谭跃龙 TAN Yue-long 鞍钢集团公司总医院骨科, 辽宁 鞍山 114003 Department of Orthopaedics, Anshan Iron and Steel Group General Hospital, Anshan 114003, Liaoning, China  
李剑 LI Jian 鞍钢集团公司总医院骨科, 辽宁 鞍山 114003 Department of Orthopaedics, Anshan Iron and Steel Group General Hospital, Anshan 114003, Liaoning, China  
吕文军 LYU Wen-jun 鞍钢集团公司总医院骨科, 辽宁 鞍山 114003 Department of Orthopaedics, Anshan Iron and Steel Group General Hospital, Anshan 114003, Liaoning, China  
张德龙 ZHANG De-long 鞍钢集团公司总医院骨科, 辽宁 鞍山 114003 Department of Orthopaedics, Anshan Iron and Steel Group General Hospital, Anshan 114003, Liaoning, China  
胡乃严 HU Nai-yan 鞍钢集团公司总医院骨科, 辽宁 鞍山 114003 Department of Orthopaedics, Anshan Iron and Steel Group General Hospital, Anshan 114003, Liaoning, China  
李吉涛 LI Ji-tao 鞍钢集团公司总医院骨科, 辽宁 鞍山 114003 Department of Orthopaedics, Anshan Iron and Steel Group General Hospital, Anshan 114003, Liaoning, China  
王洪振 WANG Hong-zhen 鞍钢集团公司总医院骨科, 辽宁 鞍山 114003 Department of Orthopaedics, Anshan Iron and Steel Group General Hospital, Anshan 114003, Liaoning, China  
陈林林 CHEN Lin-lin 鞍钢集团公司总医院骨科, 辽宁 鞍山 114003 Department of Orthopaedics, Anshan Iron and Steel Group General Hospital, Anshan 114003, Liaoning, China chenlin7890@163.com 
期刊信息:《中国骨伤》2018年,第31卷,第8期,第723-728页
DOI:10.3969/j.issn.1003-0034.2018.08.008
基金项目:
中文摘要:

目的:探讨颈前路椎间减压融合(anterior cervical decompression and fusion,ACDF)技术与颈人工间盘置换术(cervical artificial disc replacement,CADR)的临床疗效及适应证。

方法:选取2009年6月至2015年6月收治的100例颈椎病患者进行回顾性分析,男53例,女47例;年龄38~70岁。其中50例采取ACDF治疗(ACDF组),随访时间22~42(32.24±5.20)个月;50例采取CADR治疗(CADR组),随访时间23~48(30.40±5.66)个月。采用Odom标准评价两组患者临床疗效,采用JOA (17评分法)从感觉功能、运动功能、膀胱功能3个方面评估患者的脊髓功能状态,根据影像学资料对两组患者手术前后的椎间高度和颈椎曲度进行比较。

结果:术后伤口愈合情况良好,无严重并发症发生。按照Odom评定标准,ACDF组优30例,良12例,可8例;CADR组优34例,良10例,可6例。两组临床疗效差异无统计学意义(u=4.000,P=0.827)。末次随访时两组患者的感觉、运动功能评分明显改善(P<0.05),膀胱功能评分改善不明显(P>0.05),CADR组感觉、运动功能评分较ACDF组改善更明显(P<0.05)。两组患者术前椎间高度、颈椎曲度差异无统计学意义,末次随访均有不同程度的恢复,但是CADR组恢复更明显。

结论:CADR能够实现颈椎早期稳定,早期活动。在恢复颈椎生理曲度,改善感觉、运动功能上具有一定的优势,但是并不能够完全替代ACDF。
【关键词】颈椎病  减压术  脊柱融合术  颈人工间盘
 
Case control study on Mobi-C cervical artificial disc replacement and anterior cervical decompression MC+fusion for the treatment of cervical spondylosis
ABSTRACT  

Objective:To compare the clinical effects and clinical indications between Mobi-C cervical artificial disc replacement (CADR) and MC+ anterior cervical decompression and fusion(ACDF) in treating cervical spondylosis.

Methods:The clinical data of 100 patients with cervical spondylosis treated ACDF or CADR from June 2009 to June 2015 were retrospectively analyzed. There were 53 males and 47 females,aged from 38 to 70 years old. Among them,50 cases were treated by ACDF (ACDF group),follow-up time was for 22 to 42 months with an average of (32.24±5.20) months;other 50 cases were treated by CADR (CADR group),follow-up time was for 23 to 48 months with an average of (30.40±5.66) months. Odom criterion was used to evaluate the clinical effects in two groups. JOA score,including sensory function,motor function and bladder function was used to assess the spinal cord function. Preoperative and postoperative responsible intervertebral space heights,cervical curvatures were compared by image data between two groups.

Results:All incisions obtained good healing and no serious complications were found. At final follow-up,30 cases got excellent results,12 good,8 fair in ACDF group;and 34 cases got excellent results,10 good,6 fair in CADR group;there was no significant difference between two groups(u=4.000,P=0.827). At final follow-up,the scores of sensory function and motor function were obviously improved(P<0.05),and bladder function had not obviously recovered (P>0.05) in two groups;and CADR group in the scores of sensory function and motor function were obviously better than of ACDF group(P<0.05). There was no significant difference in preoperative intervertebral space height,cervical curvature between two groups,and at final follow-up both had different recovered. The recovery of CADR group was obviously better than of ACDF group.

Conclusion:CADR can quickly recover normal action for patients and retains the movement. CADR has certain advantages in recovering cervical curvature,improveing sensory function and motor function,but it is not able to completely replace ACDF.
KEY WORDS  Cervical spondylosis  Decompression  Spinal fusion  Cervical artificial disc
 
引用本文,请按以下格式著录参考文献:
中文格式:李思维,谭跃龙,李剑,吕文军,张德龙,胡乃严,李吉涛,王洪振,陈林林.Mobi-C颈人工间盘与MC+颈椎间融合器治疗颈椎病的病例对照研究[J].中国骨伤,2018,31(8):723~728
英文格式:LI Si-wei,TAN Yue-long,LI Jian,LYU Wen-jun,ZHANG De-long,HU Nai-yan,LI Ji-tao,WANG Hong-zhen,CHEN Lin-lin.Case control study on Mobi-C cervical artificial disc replacement and anterior cervical decompression MC+fusion for the treatment of cervical spondylosis[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(8):723~728
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