人工椎间盘置换术与脊柱融合术治疗颈椎病的临床分析

目的对照人工椎间盘置换术与脊柱融合术治疗颈椎病的临床效果。方法对2007年1月至2008年12月共20例颈椎病患者施行人工椎间盘置换术（人工椎间盘置换组），对24例颈椎病患者实施脊柱融合术（脊椎融合组）。手术前和术后3个月对2种手术方式疗效进行日本骨科协会（JOA）评分，并分别摄颈椎动力位x线片，观察颈椎的稳定性及活动度，比较2种手术效果。结果2种手术方法术后临床症状缓解，脊髓功能改善，均无并发症。术后3个月，所有患者JOA评分均较术前明显提高（13．3±1．9vs9．2±2．2；12．5±2．1VS8．8±2．3，P〈0．01），2种手术方法间比较，JOA评分无统计学意义（13．3±1．9vs12．5±2．1，P〉0．05）。结论人工椎间盘置换术治疗颈椎病的临床效果与脊柱融合术相同，但人工椎间盘置换术具有脊柱稳定性良好，运动功能无明显丢失，手术及临近节段的活动范围接近正常人群等优点，因此有利于预防脊柱邻近节段继发性退变。

Artificial disc replacement and spinal fusion in treating cervical spondylosis

Objectives To compare the curative effects of artificial disc replacement and spinal fusion in treating cervical spondylosis. Methods A total of 20 patients with cervical spondylosis received artificial disc re-placement and 24 cases were treated with spinal fusion. Japanese Orthopedic Association(JOA) 17 score scale was used for the neurological assessment and dynamical X-rays examination was done preoperatively and 3 month postop-eratively. The stability and the movement range of the cervical vertebrae were observed. Results All patients in two groups had improvement of clinical symptom and spinal cord function. There was no complication. Three months later, JOA score increased obviously in all cases(P <0.01) and there was no statistical significance between two groups (P>0.05). Conclusions Artificial disc replacement and the spinal fusion show the same clinical results in treating cervical spondylosis, but the artificial disc replacement has advantages like good spinal stability, no loss of motor function, motion range of close to normal population and helps prevent adjacent degeneration.