Bryan人工颈椎间盘置换术治疗颈椎病的中期疗效观察

摘要：目的观察Bryan人工颈椎间盘置换术治疗颈椎病的中期疗效。方法2005年11月至2010年5月对16例颈椎病患者行Bryan人工颈椎间盘置换术。统计并分析患者术前、术后及末次随访时的JOA评分、置换节段活动度，观察术后及末次随访时假体松动、移位、异位骨化等并发症。结果16例患者均获得随访，随访时间为12—53个月，平均24．1个月，JOA评分由术前平均（10．4±1．9）分增至术后平均（14．4±1．9）分以及末次随访平均（16．1±0．7）分，术前与术后（t=-12．215，P=0．000）、术后与末次随访（t=-4．273，P=0．001）均有显著性差异。12例患者随访时行颈椎屈伸位x线片检查，随访时间13—53月，平均24．2月，测量屈伸位X线片计算置换节段颈椎屈伸活动度（rangeofmotion，ROM），术前平均7．1°±2．6°、术后平均6．9°±1．9°、末次随访平均6．5°±1．8°，术前与术后（t=0．700，P=0．395）、术后与末次随访（t=2．132，P=0．054）均无统计学差异。无一例发生异位骨化；1例随访时出现假体周围骨吸收。结论Bryan人工颈椎间盘置换术治疗颈椎病的中期疗效满意，但仍需长时间随访以评估其远期疗效。

Midterm results of cervical disc replacement with the Bryan cervical disc prosthesis for cervical disc disorders

Objective To investigate the midterm outcomes of cervical disc replacement with Bryan cervical disc prosthesis for cervical disc disorders. Methods Sixteen patients with cervical disc disorders were performed cervical disc replacement with 16 Bryan discs from November 2005 to May 2010. The JOA score and range of motion （ROM） of the implanted disc level were measured pre-operatively, post-operatively and at final follow-up. Complications of prosthesis dislodgement, heterotopic ossification and so on were also analyzed. Results All cases obtained the follow-up with an av- erage of 24. 1 months （ranged 12 to 53 months）. The average JOA score was 10. 4 ± 1.9 pre-operatively, 14.4 ± 1.9 post-operatively and 16. 1 ± 0. 7 at final follow-up. There were significantly statistical difference between per-operatively and post-operatively （t = - 4. 273, P = 0. 001 ） and between post-operatively and final follow-up （ t = - 4. 273, P = 0. 001 ）. The ROM was 7. 1° pre-operatively, 6. 9° post-operatively and 6. 5° at final follow-up （ no statistical signifi- cance between per-operatively and post-operatively and between post-operatively and final follow-up, P 〉 0. 05 ）. One periprosthetic bone resorption was found at final follow-up, but no heterotopie ossification was observed. Conclusion The Bryan cervical disc replacement for the treatment of cervical disc disorders has a good mid-term outcome for artificial cervical disc replacement. Long-term follow-up should be taken to assess the long-term effect of the prosthesis.