新型国产人工颈椎间盘置换对山羊邻近节段影响的实验研究

目的 比较新型国产人工颈椎间盘置换与颈椎前路减压植骨融合内固定术对山羊施术节段邻近颈椎间盘退变的影响。方法 12只实验山羊随机分为3组，每组4只：间盘组（CDR组）行C_3/4间盘摘除、新型国产人工颈椎间盘植入术；融合组（ACDF组）行C_3/4间盘摘除、植骨融合内固定术；对照组不进行手术。分别于术后1、3个月行颈椎正侧位X线检查，根据改良Kellgren评分法及椎间盘相对高度测量（RDH）法进行评价。结果 动物实验中所有山羊均成活，无切口感染及肢体瘫痪。间盘组与对照组在术后1个月与3个月Kellgren评分比较，差异无统计学意义（P＞0.05）；术后1个月与术后3个月融合组Kellgren评分高于间盘组，且差异有统计学意义（P＜0.05）。三组术前的RDH比较差异无统计学意义，术后1个月及3个月融合组的RDH均低于间盘组、对照组，且与两组比较差异均有统计学意义（P＜0.05），间盘组与对照组术后RDH比较差异无统计学意义（P＞0.05）。结论 新型国产人工颈椎间盘置换可以有效防止山羊颈椎手术邻近节段的退变。

Experimental study on the effect of new home-made cervical disc replacement on adjacent segments in goats

Objective To compare the effects of new home-made artificial cervical disc replacement and anterior cervical decompression and fusion on adjacent segments in goats.Methods Twelve goats were randomly divided into 3 groups, 4 goats in each group: CDR (cervical disc replacement) group, ACDF(anterior cervical decompression and fusion) group and control group. CDR group was treated with 3/4 cervical disc removal and new home-made artificial cervical disc implantation, and ACDF group was treated with 3/4 cervical disc removal and bone graft fusion internal fixation. Cervical spine X-ray examination was performed at 1 and 3 months after surgery. Modified Kellgren scores and intervertebral disc relative disc height (RDH) were used to evaluate the efficacy.Results All experiment goats survived after operation, without incision infection and paralysis. There was no significant difference in Kellgren score between the CDR group and the control group at 1 and 3 months after surgery (P>0.05). Kellgren score of ACDF group was higher than that of CDR group at 1 month and 3 months after surgery, and the difference was statistically significant (P<0.05). There was no significant difference in preoperative RDH between the three groups. The RDH of ACDF group at 1 month and 3 months after operation was lower than that of CDR group and control group, and the differences were statistically significant (P<0.05). There was no significant difference in postoperative RDH between the CDR group and the control group (P>0.05).Conclusion New home-made artificial cervical disc replacement can effectively prevent the degeneration of adjacent cervical vertebra in goats.