作　　者： (段伟利）; (解勇）; (陆兵）; (陈红）;

机构地区： 南阳市骨科医院脊柱外科,河南南阳473000

出　　处： 《四川生理科学杂志》 2017年第3期140-142,共3页

摘　　要： 目的:观察颈椎动态稳定器(Dynamic cervical implant,DCI)治疗退变性颈椎疾病的临床疗效。方法:选择2010年1月-2014年12月在我院住院的38例颈椎病患者,其中脊髓型颈椎病15例、神经根型颈椎病23例;单节段21例、两节段17例;均采用颈前路手术,其中颈椎动态稳定器(DCI)组18例,颈椎前路椎间盘切除减压植骨融合术(Anterior cervical discectomy with fusion,ACDF)组20例。术前患者的年龄、病程、病变节段、脊髓受压情况均无统计学差异(P>0.05)。记录两种术式的手术时间、出血量、并发症,术前及术后半年采用疼痛视觉模拟评分(Visual analogue score,VAS)评估疼痛情况;采用脊髓神经功能(Japanese orthopaedic association,JOA)评分评估神经功能恢复情况,影像学测算颈椎管矢状径评估椎管减压情况。结果:随访时间平均为1.5年(11个月-24个月)。术后半年患者的疼痛改善情况、脊髓神经功能恢复情况,DCI组与传统ACDF组无统计学差异(P>0.05)。但相邻节段的活动度改变情况,DCI组优于ACDF组,有统计学意义(P<0.05)。结论:颈椎动态稳定器治疗退变性颈椎疾病的临床疗效确切,与传统的ACDF术式相当,但在减少相邻节段退变发生率方面更加显著。 Objective：To discuss the efficacy of dynamic cervical implant in treatment of degenerative cervical spine disease.Methods：From January 2010 to December 2014,38 cases of cervical spondylosis patients were enrolled in our hospital,among them,23 cases were cervical spondylotic myelopathy,15 cases were nerve root type cervical spondylosis,21 cases were single segment,17 cases were two segment.They were treated with anterior segments,including 18 cases of dynamic cervical implant（DCI）,20 cases of anterior cervical intervertebral disc resection and decompression and fusion（ACDF）.There was no significant difference on age,course of disease,lesion segment and spinal cord compression（P〉0.05）.The operative time,bleeding volume and complications were recorded.The pain was evaluated by VAS scores before operation and 6 months after operation.The nerve function recovery was evaluated by spinal cord function（Japanese Orthopaedic Association,JOA）.The spinal canal decompression was measured by the image of cervical spinal canal sagittal diameter.Results：The mean follow-up time was 1.5 years（11 months to 24 months）.There was no significant difference in improvement of pain and recovery of spinal nerve function between the DCI group and the conventional ACDF group（P〉0.05）.But the change of activity of adjacent segments,DCI group was better than ACDF group（P〈0.05）.Conclusion：Dynamic cervical implant has a good curative effect on degenerative cervical spine disease,which is equivalent to ACDF traditional operation,but more significant in reducing the incidence of the adjacent segment degeneration.

关 键 词： 颈椎动态稳定器 退变性颈椎病 颈前路减压融合术