| Mobi-C颈人工间盘与MC+颈椎间融合器 治疗颈椎病临床对比研究 |
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投稿时间：2017-05-06 修订日期：2018-07-26
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| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
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| 中文摘要:目的：对比研究融合技术（MC+）与非融合技术（Mobi-C颈人工间盘）的临床疗效及适应症。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例采用MC+治疗(ACDF)，随访时间22～42月，平均32.24±5.20月，50例行颈人工椎间盘置换(CADR)，随访时间23～48月，平均30.40±5.66月。所有病例均通过颈椎X线侧位片测量颈椎生理曲度和责任椎间隙高度；通过行颈椎MRI及CT检查排除合并有颈椎后纵韧带骨化的病例；采用Odom标准评价两组患者术后疗效，采用JOA（17评分法）从感觉功能、运动功能、膀胱功能等方面评估患者术前及终末随访脊髓功能状态，以上测量均由同一人完成并记录。结果：术后伤口愈合情况良好，所有病例无严重并发症发生。平均随访时间31.1个月。终末随访ACDF组临床功能评级：优：30例，良：12例，可：8例。终末随访CADR组临床功能评级：优34例，良10例，可6例。终末随访临床功能评级存在显著性差异；末次随访时两组患者的感觉、运动功能评分与术前比较均存在显著差异（P＜0.05）末次随访时两组患者的膀胱功能评分与术前比较均不存在显著差异（P＜0.05）。终末随访CADR组感觉、运动功能评分较ACDF组有所改善（P＜0.05）。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，ACDF适用于所有符合Mobi-C间盘置换的适用症。 |
| 【关键词】颈椎病 前路椎间减压 MC+椎间融合 Mobi-C颈人工间盘 对比研究 |
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| Comparative Study between Mobi-C Cervical Artificial Disc Replacement and Anterior Cervical Decompression MC+Fusion for the Treatment of Cervical Spondylosis |
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| ABSTRACT Objective: To compare the clinical efficacy and clinical indications of Mobi-C cervical artificial disc replacement (CADR) and anterior cervical decompression and MC+ anterior cervical decompression and fusion (ACDF) in the treatment of cervical spondylosis through retrospective analysis. Methods: 100 cervical spondylosis patients, who receive ACDF or CADR from June 2009 to June 2015 in our hospital, access to outpatient follow-up for 22 months-48 months. There were 53 males and 47 females, aged from 38 to 70 years old. The follow up in ACDF group arranged from 22 to 42 months with an average of (32.24±5.20) months．The follow up in CADR group arranged from 23 to 48 months with an average of (30.40±5.66) months． Posterior longitudinal ligament ossification was not within this range through MRI and CT scan. Odom criterion was used to evaluate the last follow up effect．For all cases, the heights of the responsible intervertebral spaces were measured through cervical lateral X-ray. Cervical physiological radian are also measured and recorded by the same people. JOA score, including motor function, sensory function and bladder function was used to assess the surgical outcome. Results：No serious complications were found and the patients were followed up from 22 to 48 months, with an average of 31.1 months. At final follow up, 30 cases got excellent results, 12 good and 8 ordinary in ACDF group. 34 cases got excellent results, 10 cases get good results and 6 ordinary results in CADR group．There is significant difference between motor function, sensory function, bladder function of two groups at final follow up (p<0.05). Motor function, sensory function and bladder function of two groups at final follow up had obviously relieved compared with pre-operation (P＜0.05). The intervertebral spaces heights and cervical physiological radian in last follow up are recovered compared with pre-operation P＜0.05). Conclusion: CADR can quickly recover normal action for patients and retains the movement. CADR has certain advantages in recovering intervertebral spaces heights and cervical physiological radian, but it is not able to completely replace ACDF. ACDF is fit for all Mobi-C disc replacement indications. |
| KEY WORDS Cervical spondylosis Cervical artificial intervertebral disc MC+ fusion Comparative study. |
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