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目的评估X线片在人工颈椎间盘置换术后随访中的价值。方法回顾性分析2003年12月至2005年5月,北京积水潭医院脊柱外科行Bryan人工颈椎间盘置换术并于2008年1~10月接受随访的病例33例。其中男25例,女8例;年龄25~70岁,平均47.2岁。单节段人工颈椎间盘置换23例,双节段人工颈椎间盘置换10例,共43个手术节段。对其术前及术后随访所摄的颈椎正位、侧位、过屈位及过伸位X线片进行影像学分析评估。结果本组随访时间36~52个月,平均43个月。43个颈椎间盘置换节段X线片显示,人工椎间盘假体前后径小于椎体前后径14个(32.6%);人工椎间盘假体发生移位3个(7.0%);颈椎间盘置换节段可见异常骨化或骨赘16个(37.2%);术前与术后颈椎整体曲度、颈椎间盘置换节段曲度、颈椎间盘置换节段活动度及颈椎间盘置换节段邻近椎间盘退变的测量评估,差异均无统计学意义(P>0.05)。结论Bryan人工颈椎间盘置换手术能够较好地保持颈椎的生理曲度和活动功能,并可一定程度上防止邻近椎间盘退变,但部分病例存在假体移位、异位骨化等现象,术前适宜的病例筛选及规范手术操作有助于避免此类并发症的发生,其远期疗效仍有待长期大样本量随访研究。
Objective To evaluate the value of X-ray in the follow-up of artificial cervical disc replacement. Methods From December 2003 to May 2005, 33 cases of Bryan artificial cervical disc replacement in Beijing Jishuitan Hospital from January to October 2008 were retrospectively analyzed. Including 25 males and 8 females; aged 25 to 70 years, mean 47.2 years. A single artificial cervical disc replacement in 23 cases, double-section artificial cervical disc replacement in 10 cases, a total of 43 surgical segments. Preoperative and postoperative follow-up of the cervical spine, lateral position, flexion and extension of the X-ray imaging analysis. Results The follow-up time was 36 to 52 months in this group, with an average of 43 months. Forty-three cervical intervertebral disc segments showed anterior and posterior diameters less than 14 anterior and posterior diameters (32.6%), three prosthetic discs (7.0%), and cervical disc replacement segments 16 cases of abnormal ossification or osteophyte (37.2%); preoperative and postoperative cervical curvature, cervical intervertebral disc segmental curvature, cervical intervertebral disc replacement segment mobility and intervertebral disc degeneration adjacent disc degeneration measurement There was no significant difference between the two groups (P> 0.05). Conclusion Bryan artificial cervical disc replacement surgery can better maintain the physiological curvature and mobility of the cervical spine, and to some extent prevent the degeneration of adjacent disc, but in some cases there prosthesis displacement, heterotopic ossification and other phenomena, preoperative Appropriate screening of cases and standard operation help to avoid the occurrence of such complications, the long-term efficacy remains to be long-term large sample size follow-up study.