单节段ProDisc-C颈椎人工椎间盘置换术对颈椎曲度和活动度的影响

Cervical alignment and range of motion after single-level ProDisc-C replacement

中文关键词:  人工椎间盘置换术  ProDisc-C  脊柱功能单位角度  颈椎曲度  颈椎活动度

英文关键词:Artificial disc replacement  ProDisc-C  Functional spinal unit angle  Cervical alignment  Cervical range of motion

中文摘要:

  【摘要】目的：观察单节段ProDisc-C颈椎人工椎间盘置换术后置换节段活动度和颈椎曲度变化情况，分析ProDisc-C人工椎间盘置换术的效果。方法：2006年6月~2008年9月对53例颈椎病患者行单节段前路减压、ProDisc-C人工椎间盘置换术，置换节段C3/4 7例，C4/5 10例，C5/6 27例，C6/7 9例。应用医学影像存储与传输系统（PACS）测量术前和末次随访时置换节段活动度（ROM）、置换节段脊柱功能单位 （functional spinal unit，FSU）Cobb角和颈椎整体曲度（C2~C7 Cobb角）。结果：随访3~36个月，平均13.8个月。术前置换节段ROM为8.6°±3.7°，末次随访时为9.7°±3.5°，有统计学差异（P<0.05）；术前FSU Cobb角（前凸为正值）为0.1°±4.8°，末次随访时为3.6°±4.5°，有统计学差异（P<0.05）；术前颈椎整体曲度为7.0°±10.2°，末次随访时为8.0°±10.4°，无统计学差异（P>0.05）。结论：单节段ProDisc-C颈椎人工椎间盘置换术后置换节段活动度较术前增大，颈椎整体曲度无明显变化，FSU前凸增大，对于术前病变节段FSU生理前凸变小或轻度后凸的拟行颈椎人工椎间盘置换的患者可选择ProDisc-C假体。

英文摘要:

  【Abstract】 Objective：To investigate the cervical alignment and range of motion（ROM） after single-level ProDisc-C replacement.Method：53 patients underwent single-level anterior cervical decompression and ProDisc-C replacement between June 2006 and September 2008.There were 7 cases of C3/4，10 cases of C4/5，27 cases of C5/6 and 9 cases of C6/7 involved respectively.Segmental ROM，angular variation at functional spinal unit（FSU），Cobb angle of lordosis from C2 to C7 were measured and compared on dynamic X-rays by picture archive & communication system（PACS）.Result：The follow-up averaged 13.8 months（range，3-36 months）.The segmental ROM was 8.6°±3.7° and 9.7°±3.5° for baseline and final follow-up respectively with statistical significance（P<0.05）.The angular variation at FSU was 0.1°±4.8° and 3.6°±4.5° for baseline and final follow-up respectively with statistical significance（P<0.05）.The lordosis Cobb angle of C2-C7 was 7.0°±10.2° and 8.0°±10.4° for baseline and final follow-up respectively without statistical significance（P>0.05）.Conclusion：After single-level ProDisc-C replacement，increase of segmental ROM，maintaining of cervical alignment as well as the increased FSU lordosis are evidenced.The ProDisc-C prosthesis is recommended for the candidates with decreased lordosis or slight FSU kyphosis.