[1]史晓萌 李春根△ 柳根哲 尹辛成 陈超 郑皓云 祝永刚 赵思浩.颈椎下终板形态对人工颈椎间盘置换术后临床疗效的影响[J].中国中医骨伤科杂志,2022,30(05):16-22.
　SHI Xiaomemg LI Chungen LIU Genzhe YIN XinchengCHEN Chao ZHENG Haoyun ZHU Yonggang ZHAO Sihao.Efficacy of Inferior Endplate Morphology on Clinical Effect ofArtificial Cervical Disc Replacement[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(05):16-22.
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颈椎下终板形态对人工颈椎间盘置换术后临床疗效的影响()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年05期
页码:
16-22
栏目:
临床研究
出版日期:
2022-05-15

文章信息/Info

Title:
Efficacy of Inferior Endplate Morphology on Clinical Effect ofArtificial Cervical Disc Replacement
文章编号:
1005-0205(2022)05-0016-07
作者:
史晓萌1 李春根2△ 柳根哲2 尹辛成2 陈超2 郑皓云2 祝永刚2 赵思浩2
1北京中医药大学(北京,100029)
2首都医科大学附属北京中医医院骨科
Author(s):
SHI Xiaomemg1 LI Chungen2△ LIU Genzhe2 YIN Xincheng2CHEN Chao2 ZHENG Haoyun2 ZHU Yonggang2 ZHAO Sihao2
1Beijing University of Chinese Medicine, Beijing 100029, China; 2Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China.
关键词:
颈椎病; 人工颈椎间盘置换术; 终板形态; 临床疗效; 颈椎曲度
Keywords:
cervical spondylosis;  artificial cervical disc replacement;  endplate morphology;  clinical effects;  cervical curvature
分类号:
R681.5
文献标志码:
A
摘要:
目的:观察颈椎下终板形态对人工颈椎间盘置换术(Artificial Cervical Disc Replacement,ACDR)的影响。方法:回顾性分析2018年1月至2020年9月收治的行单节段ACDR的颈椎病患者44例。根据术前颈椎下终板穹隆顶点位置将患者分为3组:A组(Ⅰ型),穹隆顶点位置靠前; B组(Ⅱ型),穹隆顶点位置居中; C组(Ⅲ型),穹隆顶点位置靠后。比较患者的临床评分和影像学参数,并按Odom’s标准评定治疗效果。结果:椎体下终板矢状径平均为(17.13±2.62)mm,下终板穹隆高度平均为(2.18±0.75)mm。终板形态分布:Ⅰ型8例(18%),Ⅱ型13例(30%),Ⅲ型23例(52%)。术后平均随访(21.73±8.62)个月,VAS、NDI评分较术前下降,差异有统计学意义(P<0.05); JOA评分较术前升高,改善率为73.13%,差异有统计学意义(P<0.05)。与术前相比,FSU、SVA、手术节段活动度及整体活动度,差异有统计学意义(P<0.05); C2～C7 Cobb角、T1倾斜角差异无统计学意义(P>0.05)。3组终板形态之间,C2～C7 Cobb角在末次随访时差异有统计学意义(P<0.05)。邻近节段退变(ASD)2例(4.55%)。Odom’s标准评定结果:优25例,良13例,可4例,差2例,优良率为86.36%。结论:ACDR术后短期随访临床疗效满意,颈椎下终板形态对术后颈椎整体曲度恢复产生一定影响。
Abstract:
To observe the efficacy of inferior endplate morphology on artificial cervical disc replacement(ACDR). Methods: A retrospective analysis was performed on 44 patients with ACDR with cervical spondylosis admitted to hospital from January 2018 to September 2020. Patients were divided into three groups according to the position of the apex of the lower endplate dome: group A(type Ⅰ),the dome apex was located in front; group B(type Ⅱ), the dome apex was located in the middle; group C(type Ⅲ), the dome apex was located at the back. The clinical scores and imaging parameters of patients with different endplate morphology before and after operation and in each group were compared, and the treatment efficacy was evaluated according to Odom’s standard. Results:The sagittal diameter of the upper endplate was recorded as(17.13±2.62)mm, and the average dome height of the lower endplate was recorded as(2.18±0.75)mm. Endplate morphology distribution was recoded as 8 cases in type Ⅰ(18%),13 cases in type Ⅱ(30%),23 cases in type Ⅲ(52%). They were followed up by(21.73±8.62)months. Compared with the preoperative results, the VAS and NDI scores were shown statistically significant differences(P<0.05). The improvement rate of JOA score was recorded as 73.13% and the difference was shown statistically significant(P<0.05). Compared with before operation, FSU, SVA, range of activity of operation segment and total activity were shown significantly different(P<0.05). C2 to C7 Cobb angle and T1 inclination angle were shown no significant difference(P>0.05). The difference of C2 to C7 Cobb angle between the three groups at the last follow-up was shown statistically significant(P<0.05). Adjacent segment degeneration(ASD)was occurred in 2 cases(4.55%). Odom’s standard evaluation results were recorded as excellent 25 cases, good 13 cases, fair 4 cases, poor 2 cases, excellent and good rate 86.36%. Conclusion:The clinical efficacy of patients after ACDR is satisfactory, the shape of endplate has influence on postoperative cervical curvature.

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备注/Memo

备注/Memo:
△通信作者 E-mail:Leechungen@126.com
更新日期/Last Update: 1900-01-01