Bryan人工椎间盘置换术治疗脊髓型颈椎病

目的总结应用Bryan人工椎间盘置换术治疗脊髓型颈椎病的疗效。方法回顾性分析应用Bryan人工椎间盘置换术治疗的20例脊髓型颈椎病患者，共25个置换节段，其中单节段15例，双节段5例。应用JOA17分法评价术前和末次随访时的临床神经功能状况，并作统计学检验。观察末次随访时颈椎侧位X线片上假体与椎体的相互位置关系以及假体所在椎间隙的活动度。结果所有病人得到随访，随访时间3～24个月，平均15个月。病人术后症状有明显缓解，JOA评分由术前平均10．4分上升至术后平均15．2分。术后随访未见有假体松动、下沉和周围骨化融合，置换间隙前屈后伸活动范围平均为（4．8±1．7）°。结论Bryan人工椎间盘置换术早期临床效果良好，能达到确切的稳定性和部分的活动度保留。

Treatment of cervical spondylotic myelopathy with Bryan artificial disc replacement

Objective To explore the effect of Bryan disc replacement in the treatment of cervical spondylotic myelopathy. Methods The clinical data of 20 patients of cervical spondylotic myelopathy with 25 Bryan disc replacement including 15 cases of single- level and 5 of double - level were analyzed retrospectively. JOA 17 score scale was used for the neurological assessment of preoperation and final follow up. Radiological study were performed at the final follow up in all cases in order to evaluate for the position between implanted prosthesis and vertebral body and the range of motion（ROM） of operative segment. Results All patients were followed up from 3 to 24 months （mean, 15 months）. All the symptoms relieved obviously after operation in all patients. JOA score increased from average 10. 4 preoperatively to 15. 2 postoperatively. There was no prosthesis displacement, subsidence, loosening or spontaneous fusion in all the operative segments within the follow-up. Radiographic examination showed all the replaced segments were stable and restored mean （4.8±1.7）° of normal ROM in flex and extension position. Conclusion The Bryan cervical disc replacement for the treatment of cervical spondylotic myelopathy has offered an exact stability and partial reservation of normal movement postoperatively and had an excellent short term clinical outcome.