孙 宇,赵衍斌,周非非,张凤山,潘胜发,周 方,刘忠军.颈椎人工椎间盘置换后对相邻节段退变的影响[J].中国脊柱脊髓杂志,2011,(6):474-479. |
颈椎人工椎间盘置换后对相邻节段退变的影响 |
中文关键词: 颈椎人工椎间盘置换 相邻节段退变 相邻节段疾病 |
中文摘要: |
【摘要】 目的:观察单节段颈椎人工椎间盘置换术后相邻节段退变情况。方法:截止到2010年10月在我院行单节段颈椎人工椎间盘置换术后随访20个月以上且资料完整、既往无颈椎手术史的患者80例,置换节段为C3/4 8例,C4/5 15例,C5/6 49例,C6/7 8例;41例为Bryan Disc置换术,39例为ProDisc-C置换术。对比术前和末次随访时X线片、MRI相邻节段退变情况。相邻节段退变定义为X线片上椎间隙高度丢失与术前相比大于10%,形成肉眼可见新生骨赘或原有骨赘增大,前纵韧带钙化;在MRI T2加权像上采用Miyazaki颈椎间盘退变分级方法观察相邻节段椎间盘退变情况。结果:随访20~64个月,平均38个月。末次随访时X线片上160个相邻节段中,8个下相邻节段因肩部X线遮挡而显示不清,符合条件的152个相邻节段中21个(13.8%)出现退变,其中Bryan Disc置换术组退变发生率为10.0%,ProDisc-C置换术组退变发生率为18.1%;47例患者获得了MRI随访,94个相邻节段中14个(14.9%)椎间盘退变分级加重1级,其中Bryan Disc置换术组退变加重发生率为12.5%,ProDisc-C置换术组退变加重发生率为22.7%。未出现相邻节段疾病。结论:颈椎人工椎间盘置换术后平均38个月随访相邻节段退变表现加重者不足15%,不同类型的假体对相邻节段退变的影响可能存在一定差异。 |
Effect of cervical disc arthroplasty on adjacent segment degeneration |
英文关键词:Cervical disc replacement Adjacent segment degeneration Adjacent segment disease |
英文摘要: |
【Abstract】 Objective:To investigate the adjacent segment degeneration after single level cervical disc arthroplasty.Method:Patients received single level cervical arthroplasty in our institute were reviewed retrospectively.Up to October 2010,a total of 80 patients gained at least 20 months′ follow-up.There were 8 cases of C3/4,15 C4/5,49 C5/6 and 8 C6/7.41 patents received Bryan Disc cervical prosthesis and 39 received ProDisc-C prosthesis.Adjacent segment degeneration was evaluated on X-ray and magnetic resonance imaging(MRI) at preoperative and final follow-up.X-ray based adjacent segment degeneration included the presence of any of the following parameters:narrowing of disc space>10%,new anterior or/and extended osteophyte formation,calcification of anterior longitudinal ligament.Cervical disc degeneration was evaluated according to Miyazaki′s grading system based on T2-weighted MRI.Result:The mean follow-up period was 38 months(range,20-64 months).Of 160 segments at final follow-up,8 distal adjacent segments were excluded due to unavailability of X-ray,adjacent segment degeneration was observed in 21 of 152 segments(13.8%) based on X-ray findings.The rate of adjacent segment degeneration for Bryan disc group was 10.0%,which was lower than that of ProDisc-C group(18.1%).47 patients gained MRI follow-up,and adjacent segment degeneration was observed in 14 of 94 segments(14.9%).The rate of MRI-based adjacent segment degeneration for Bryan Disc group was 12.5%,which was also lower than that of ProDisc-C group(22.7%).No adjacent segment disease developed at final follow-up.Conclusion:Less than 15% cases develop adjacent segment degeneration 38 months after cervical disc arthroplasty,and the effect may vary between different prosthesis. |
投稿时间:2011-12-26 修订日期:2011-02-21 |
DOI:10.3969/j.issn.1004-406X.2011.6.474.5 |
基金项目: |
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