单节段半限制型Activ-C人工椎间盘置换术的早期疗效观察

目的：观察半限制型Activ-C人工椎间盘置换术治疗单节段颈椎病的早期临床疗效。方法2009年7月至2012年9月，在我院接受Activ-C人工椎间盘置换术并获得随访的单节段颈椎病患者共28例，男18例，女10例，年龄32～62岁，平均45.2岁。采用日本骨科协会（Japaneseorthopedicassociation，JOA）评分、颈椎活动障碍指数（neckdisabilityindex，NDI）和疼痛视觉模拟评分（visualanaloguescale，VAS）评价术后症状改善程度，比较手术前后的颈椎曲度、手术节段活动度变化，观察统计手术并发症情况。结果随访时间12～36个月，平均17.8个月，JOA脊髓功能评分从（8.5±2.5）分增加至（14.8±1.5）分，NDI评分从（24.8±6.9）分下降至（7.3±4.8）分，颈部VAS评分从（6.8±1.3）分下降至（1.2±0.4）分，上肢VAS评分从（7.4±1.2）分下降至（1.1±0.4）分，均有明显改善（P＜0.05）。置换节段活动度从术前平均（9.6±4.3）°增加至末次随访时平均（10.8±3.5）°，差异无统计学意义（P＞0.05）；颈椎整体曲度术前为（12.9±10.5）°，末次随访时为（15.4±9.1）°，但差异无统计学意义（P＞0.05）。结论单节段半限制型Activ-C人工椎间盘置换术可有效改善颈椎病患者的临床症状，维持颈椎的生理曲度和活动度，早期临床疗效满意。

Observation of early results after single-level semi-constrained Activ-C cervical disc arthroplasty

Objective To evaluate the early clinical results of semi-constrained Activ-C cervical disc arthroplasty for single-level cervical spondylosis. Methods From July 2009 to September 2012, 28 patients with single-level cervical spondylosis underwent Activ-C cervical disc arthroplasty and were followed up. There were 18 males and 10 females, whose mean age was 45.2 years old （ range： 32-62 years ）. The Japanese Orthopedic Association （ JOA ） scores, Neck Disability Index （ NDI ） and Visual Analogue Scale （ VAS ） were used to evaluate the postoperative improvement of symptoms, compare the preoperative and postoperative cervical curvature and segmental range of motion （ ROM ） and record the operative complications. Results The mean follow-up period was 17.8 months （ range：12-36 months ）. The mean JOA score was improved from （ 8.5±2.5 ） points to （ 14.8±1.5 ） points, and the mean NDI score was decreased from （ 24.8±6.9 ） points to （ 7.3±4.8 ） points. The mean VAS scores of neck and arm pain were （ 6.8±1.3 ） points and （ 7.4±1.2 ） points respectively before the operation, which were decreased to （ 1.2±0.4 ） points and （ 1.1±0.4 ） points respectively in the latest follow-up. Significant differences existed between the preoperative and postoperative scores mentioned above （ P0.05 ）. The preoperative cervical Cobb angle was （ 12.9±10.5 ） °, which was increased to （ 15.4±9.1 ） ° in the latest follow-up, with no statistically signiifcant differences （ P〉0.05 ）. Conclusions Early clinical results of single-level semi-constrained Activ-C cervical disc arthroplasty are satisfactory, with the clinical symptoms improved and the cervical curvature and ROM preserved in the patients with cervical spondylosis.