18例Charité人工腰椎椎间盘置换术后的中期随访结果

目的探讨Charité人工腰椎椎间盘置换治疗退行性腰椎椎间盘疾病及腰椎椎间盘突出症的效果及安全性。方法 2005年1～11月,采用Charité人工腰椎椎间盘置换术治疗18例腰椎椎间盘突出症患者,共计20个椎间隙。回顾性分析患者的临床资料,对比术前与术后以及术前与末次随访时的关节活动度（range of motion,ROM）、视觉模拟评分（visual analog scale,VAS）及Oswestry功能障碍指数（Oswestry disability index,ODI）,统计并发症。结果随访时间平均为45.6个月。术前平均ROM为8.1°,术后8.8°（P〉0.05）,末次随访8.4°（P〉0.05）;术前VAS平均72.8分,术后为32.2分（P〈0.01）,末次随访时为28.2分（P〈0.01）;术前ODI平均为57.0分,术后为31.4分（P〈0.01）,末次随访为27.6分（P〈0.01）。1例在随访半年时自述逆向射精。1例双节段置换的患者发生了异位骨化。无其他并发症。结论人工腰椎间盘置换术操作简便,疗效满意,并发症少,是治疗退行性腰椎间盘疾病和腰椎间盘突出症的一种安全、有效的方法 。

Clinical study of 18 patients with Charitéartificial disc after midterm follow-up

Objective To investigate the curative effect and safety of lumbar total disc replacement with Charitéartificial disc in treatment of degenerative disc disease and lumbar disc herniation. Methods A total of 18 patients treated with Charitéartificial discs in 20 segments during January to November 2005 were analyzed retrospectively. Preoperative range of motion (ROM) of the operated space, visual analog scale (VAS) and the score of Oswestry disability index (ODI) questionnaire were documented and compared with both the postoperative data and data at the last follow-up. Complication was also recorded. Results The mean time of follow-up was 45.6 months. The mean ROM was 8.1°preoperatively, 8.8°postoperatively (P>0.05) and 8.4°at the last follow-up (P>0.05). The average VAS score was 72.8 preoperatively, 32.2 postoperatively (P<0.01) and 28.2 at the last follow-up (P<0.01). The average ODI score was 57.0 preoperatively, 31.4 postoperatively (P<0.01) and 27.6 at the last follow-up (P <0.01). Retrograde ejaculation occurred in 1 patient after half a year postoperatively and heterotopic ossification in 1 patient who underwent bi-segmental procedures. No other complication was found. Conclusion Lumbar total disc replacement is a safe and effective way to treat degenerative disc disease and lumbar disc herniation with satisfied outcome and minimal complication.