颈椎动态稳定器治疗单节段颈椎病的回顾性研究

目的 回顾性研究颈椎动态稳定器（dynamic cervical implant，DCI）治疗颈椎病的手术治疗效果。方法 对16例颈椎间盘切除减压DCI植入的颈椎病患者进行了回顾性研究，手术节段包括C4-5、C5-6、C6-7，其中C4-5节段3例，C5-6节段7例，C6-7节段6例，分别在术前、术后3个月、6个月、1年获得了完整的随访资料。临床评分采用疼痛视觉模拟评分（visual analogue score，VAS）和颈椎功能障碍指数（neck disability index，NDI）分别进行术前术后疗效的对比。记录手术时间、术中出血量，观察颈椎过伸过屈位X线片评价假体的稳定性，是否有假体位移、下沉，以及邻近节段活动度等的影像学表现。结果 术后3个月、6个月、1年的资料显示NDI评分、颈痛VAS和上肢痛VAS与术前评分相比，差异均有统计学意义（P<0.05）。手术节段保留明显的活动度，相邻节段未见到明显的退变不稳。随访过程未见到假体松动、移位，围手术期无明显神经损伤、感染病例。结论 单节段颈椎病前路间盘切除减压DCI动态内固定术具有良好的手术治疗效果，术后1年随访显示该术式保留手术节段和邻近节段的活动度，维持改善患者颈椎的矢状面曲线。

Retrospective study of cervical dynamic stabilization in the treatment of single level cervical spondylosis

Objective To study dynamic cervical implant (DCI) in the treatment of single level operation curative effect of cervical spondylosis. Methods We reviewed 16 cervical spondylosis patients treated with DCI. Surgical levels include C4-5, C5-6, C6-7, among them 3 cases at C4-5, 7 cases at C5-6, 6 cases at C6-7. All patients had complete follow-up data, including preoperative, postoperative 3 months, postoperative 6 months and postoperative 12 months. Comparison of preoperative and postoperative clinical score by visual analogue score (VAS) and neck disability index (NDI) were done. The operation time, amount of blood loss, cervical extension and flexion prosthetic stability, displacement of the prosthesis, subsidence, and adjacent segment motion imaging were recorded. Results Compared with preoperative NDI and VAS score, significance were found at 3 months, 6 months and 12 months follow-up, VAS and NDI scores significantly improved. Good mobility was maintained and no adjacent segment degeneration was observed. No internal fixation loosening, displacement, no perioperative nerve injury and infection cases occurred. Conclusion 1 year follow-up results showed that single level cervical spondylosis decompression and internal dynamic fixation with DCI has excellent surgical outcomes for cervical spondylosis, maintaining index and adjacent segmental mobility, and improve the cervical sagittal alignment.