ProDisc-C人工颈椎间盘置换术后中长期随访病例的异位骨化情况分析

Analysis of heterotopic ossification in patients with medium and long term follow-up after ProDisc-C artificial cervical disc replacement

中文关键词:  人工颈椎间盘置换术  异位骨化  ProDisc-C假体

英文关键词:Artificial cervical disc replacement  Heterotopic ossification  ProDisc-C prosthesis

中文摘要:

  【摘要】目的：观察ProDisc-C人工颈椎间盘置换术后中长期影像学随访结果。方法：2006年6月～2008年11月我院骨科行单节段ProDisc-C人工颈椎间盘置换术治疗患者中，36例患者获得中长期随访，男22例，女14例，平均年龄44.7±8.1岁（27~62岁）。所有患者过伸过屈位X线片上采用McAfee分级评估假体置换节段异位骨化发生情况和异位骨化位置，采用White方法测量术前和末次随访的置换节段活动度，侧位X线片上采用Kellgren-Lawrence分级评估手术节段术前退变情况，分析其与末次随访时异位骨化的关系。结果：平均随访时间为108.6±27.0个月。36个手术节段术前活动度为9.0°±3.6°，末次随访时活动度为6.4°±3.2°，较术前明显降低（P＜0.05）。36个手术节段中有25个（69.4%）节段出现异位骨化，根据McAfee异位骨化分级，其中Ⅰ级异位骨化1个节段，Ⅱ级6个节段，Ⅲ级14个节段，Ⅳ级4个节段。出现异位骨化的25个节段中，异位骨化主要位于假体后方者11例，异位骨化主要位于假体前方者14例。手术节段术前退变Kellgren-Lawrence分级与异位骨化无明显相关性（P＞0.05）。结论：ProDisc-C人工颈椎间盘置换术后中长期随访异位骨化发生率高，降低了置换节段的活动度。

英文摘要:

  【Abstract】 Objectives: To evaluate the radiographic outcomes of ProDisc-C artificial cervical disc replace?鄄ment. Methods: From June 2006 to November 2008 in our hospital, 36 patients underwent single segment ProDisc-C artificial cervical disc replacement and had medium and long term follow-up, Among them, 22 cases were males and 14 cases were females; the average age was 44.7±8.1 years(27-62 years). Flexion-ex?鄄tension lateral images were performed at baseline and at final follow-up to evaluate the heterotopic ossifica?鄄tion by McAfee method. Preoperative and final follow-up segmental activity was measured using White method. Lateral X-ray image was used to evaluate the preoperative degeneration of the surgical segment by Kellgren-Lawrence classification, its relationship with heterotopic ossification(HO) at final follow-up was ana?鄄lyzed. Results: The mean follow-up time was 108.6±27.0 months. The range of motion at the operated level was 9.0°±3.6° at baseline and 6.4°±3.2° at final follow-up. 25 of 36 levels(69.4%) developed HO. According to McAfee′s classification, one level was classified as grade Ⅰ, 6 levels were classified as grade Ⅱ, 14 lev?鄄els were classified as grade Ⅲ and 4 levels as grade Ⅳ. Eleven of 25 HO were detected on the posterior margin of the prosthesis; 14 HO were detected on the anterior margin of the prosthesis. There was no signifi?鄄cant correlation between Kellgren-Lawrence classification and HO(P＞0.05). Conclusions: Heterotopic ossifica?鄄tion was common after ProDisc-C arthroplasty, which decreased the range of motion.