双节段Bryan人工颈椎椎间盘置换联合双节段融合治疗多节段颈椎椎间盘突出症:5年随访结果

被引：14

作者：

丁琛 ^{[1
]}

刘浩 ^{[1
]}

胡韬 ^{[1
]}

石锐 ^{[1
]}

李涛 ^{[1
]}

洪瑛 ^{[2
]}

宋跃明 ^{[1
]}

刘立岷 ^{[1
]}

曾建成 ^{[1
]}

孔清泉 ^{[1
]}

机构：

[1] 四川大学华西医院骨科

[2] 四川大学华西医院手术室

来源：

脊柱外科杂志 | 2011年 / 9卷 / 05期

关键词：

颈椎; 椎间盘移位; 人工关节; 关节成形术,置换; 脊柱融合术;

D O I：

暂无

中图分类号：

R687.3 [骨骼手术];

学科分类号：

100220 [骨科学];

摘要：

目的观察采用相邻双节段Bryan人工颈椎椎间盘置换联合双节段植骨融合术治疗多节段颈椎椎间盘突出症的中远期临床效果,并回顾置换联合融合手术(hybrid surgery,HS)的文献报道。方法 2004年12月对1例C3/C4/C5/C6/C7椎间盘突出的男性患者实施了C4/C5/C6 Bryan ACDR,C3/C4和C6/C7椎间盘切除、椎体间钛网植骨、Zephir钢板内固定术。分别于术前及术后2周、1年、2年、5年完成SF-36生活质量量表、日本骨科学会(JapaneseOrthopaedic AssociationJ,OA)评分(17分法),颈椎功能障碍指数(neck disability index,NDI)、颈部及上肢疼痛视觉模拟量表(visual analogue scale,VAS)评分;术后各随访时点行影像学检查观察Bryan人工颈椎椎间盘位置、椎间活动度、钛网和钢板的位置及植骨融合情况。结果术后2周1、年、2年随访上述各量表评分均反映临床效果良好,但术后5年随访,患者出现中等程度颈痛及双上肢麻木,其远期临床效果有所下降。随访中影像学检查示Bryan假体及钛网钢板位置均良好,Bryan假体活动度正常,植骨融合良好。结论 HS手术治疗多节段颈椎椎间盘突出症的近中期临床效果良好,远期临床效果尚可,手术安全。该术式兼顾颈椎的活动度和稳定性,为多节段颈椎椎间盘突出症的手术治疗提供了新的选择。

引用

收藏

页码：288 / 292

页数：5

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