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IR@PKUHSC  > 北京大学第三临床医学院  > 骨科  > 期刊论文
学科主题: 骨科学
题名:
Bryan人工颈椎间盘置换术的中期随访结果分析
其他题名: The application of cervical spine arthroplasty with Bryan disc and mid-term clinical and radiological follow-up results
作者: 孙宇; 赵衍斌; 周非非; 刘忠军
关键词: 椎间盘 ; 颈椎病 ; 假体和植入物 ; Intervertebral disk ; Cervical spondylosis ; Prostheses and implants
刊名: 中华外科杂志
发表日期: 2008
DOI: 10.3321/j.issn:0529-5815.2008.05.005
卷: 46, 期:5, 页:333-337
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 观察Bryan人工颈椎间盘置换术后临床和影像学结果以及相邻节段退变的情况.方法 回顾性分析术后随访时间超过2年的26例单节段置换患者的临床资料,临床效果采用JOA和Odom评分进行评定.采用x线片观察手术节段活动度和椎旁骨化.采用X线片和MRI观察对比相邻节段退变情况.术前X线片示置换节段的活动度为2°~12°,平均为6.9°.结果 (1)临床结果:18例脊髓型颈椎病患者随访时JOA评分平均16分,平均改善率84%,8例神经根型颈椎病患者随访时临床症状全部消失.Odom分级:优秀15例,良好7例,一般4例.(2)X线片:术后置换节段的活动度为1°~14°,平均7.8°;7例出现假体周围异位骨化,仅1例假体运动消失,其余6例平均活动度为5.3°.相邻节段椎间隙高度术后无明显变化.(3)MRI T2加权像:根据Pfirrmann椎间盘退变分级方法,相邻节段椎间盘的分级术后无明显加重表现;相邻节段黄韧带肥厚对椎管的侵占率术后无明显加重;但是上下相邻椎间盘侵占率均略有增加.结论 Bryan人工颈椎间盘置换术保留了置换节段的运动性,避免了相邻节段的加速退变,2年以上随访效果优良. Objective To study the clinical and radiological outcome of Bryan cervical discreplacement and the degenerative status on adjacent segments.Methods The data of 26 cases of single level disc replacement with minimal 2 years follow-up were reviewed.Clinical outcome was assessed with the JOA 17 score scale and Odom's score.Radiological assessment including range of motion and heterotopic ossification of operated level were recorded.Adjacent level degeneration on X-ray and MRI scan at baseline and at follow-up were compared.Resuits (1)Clinical outcome:the average JOA score was 16 with 84% improvement ratio at final follow-up in 1 8 cases of cervical myelopathy.Eight cases of radiculopathy were fully recovered.According to the Odom's criteria 15 cases had an excellent outcome,7 good,4 fair,and no case of poor result.(2)On X-ray:The range of motion(ROM)at operated level was 6.9°(2°-12°)at baseline and 7.8°(1°-14°)at final follow-up.The heterotopic ossification around the prosthesis was observed in 7 cases and only 1 case lost movement.The average ROM was 5.3 degree in other 6 cases. There was no obvious change of disc height at adjacent levels.(3)On MRI:There was no deterioration of disc degeneration at adjacent levels at final follow-up according to Pfirrmann's classification.There was no further ligamentum flavum impingement into spinal canal observed at adjacent levels but the disc budge slightly increased at both upper and lower adjacent level at final follow-up.Conclusions The motion at operated level is preserved after minimal 2 years Bryan disc replacement with satisfied clinical outcome.The deterioration of disc degeneration at adjacent levels may be postponed.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/70573
Appears in Collections:北京大学第三临床医学院_骨科_期刊论文

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作者单位: 北京大学第三医院骨科,100083

Recommended Citation:
孙宇,赵衍斌,周非非,等. Bryan人工颈椎间盘置换术的中期随访结果分析[J]. 中华外科杂志,2008,46(5):333-337.
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