【摘要】 目的　探讨颈椎Bryan人工间盘置换手术的临床使用要点和手术适应证。方法　对2003年12月至2004年6月北京积水潭医院脊柱外科共进行的29例33个椎间盘的颈椎人工间盘的置换手术进行了随诊。随诊时间最长6个月,平均3 7个月。其中脊髓型颈椎病16例,颈椎间盘突出症13例。单间隙25例,双间隙4例。其中男15例,年龄32 ~60岁,平均47岁。女14例。年龄40~65岁,平均49岁。本组病例均采用Bryan人工椎间盘假体,该假体采用外壳和聚氨酯髓核构成。假体上下终板接触面有钛微孔喷涂层利于骨长入。从而使假体获得长期稳定性。手术严格按照Bryan人工椎间盘假体置入标准操作程序进行。术后颈托外固定2周。结果JOA评分改善率56%。椎间活动度:矢状位术前平均活动度12. 2度,术后10 .9度,冠状面平均5 7度,邻近间隙矢状位术前平均活动度10 .9度,术后9. 4度,患者满意度94%。与一般前路固定术比较,患者恢复快,早期可以颈部活动,颈部僵直感少。结论　29例33个人工间盘置换手术取得满意的近期疗效,颈椎运动范围得到一定保持。与前路融合手术最大的不同是患者恢复快,颈部支具佩带时间短,没有颈椎受限的感觉。更多还原

【Abstract】 Objective To summarize the experience of cervical artificial disc replacement. Methods The clinical data of 29 cases undergoing standar d Bryan artificial disc replacement, 15 males, aged 47 (32~60), and 14 females, aged 49 (40~65), 16 with cervical spondylotic myelopathy and 13 with cervica l disc herniation, were analyzed. Twenty patients underwent replacement of one d isc and 4 patients underwent replacement of 2 discs. A follow-up of 3.7 months was conducted. Results No complication was seen intra-operatively and post-operatively. All patients felt improvement of preoperative symptoms immed iately postoperatively and returned to work 2~4 weeks after the operation. The J OA scoring was improved by 56%. The average motion range of the operative interv ertebral space was 12.2 degrees before operation and was 10.9 degrees after the operation in vertical direction. The average motion range of the operative inter vertebral space in vertical direction was 12.2 degrees before operation and was 10.9 degrees after the operation. The average motion range of the adjacent inte rvertebral space in vertical direction was 10.9 degrees before operation and was 9.4 degrees after the operation. The satisfaction rate of the patients was 94%. Conclusion The short-term effect of standard Bryan artif icial disc replacement is satisfactory.更多还原