【摘要】 目的观察颈椎动态稳定器(DCI)置入术治疗颈椎病的早期疗效及术后改善情况,探讨其临床治疗效果及对术后变化的影响。方法对2010年10月至2012年4月收治的符合DCI置入术指征的颈椎病患者共23例进行随访研究,所有患者均行椎前路椎间盘切除、椎管减压后DIC置入术。术前及每次术后随访均使用颈部疼痛视觉模拟评分(VAS)、日本矫形外科协会脊髓功能评定法(JOA)、颈椎残障功能指数(NDI)评价等评估患者手术前后症状缓解及功能恢复情况。测定患者手术节段、临近上下两节段的Cobb角,并计算该节段的活动度(ROM)。结果所有患者均获随访,随访时间8~18个月,平均(14.5±3.5)个月。患者DCI置入术后末次随访JOA功能评分[(15.2±3.1)分]、VAS[(2.8±2.4)分]、NDI评分[(18.3±2.2)分]较术前[(8.3±1.1)、(8.0±0.6)、(40.1±1.6)分]改善明显,差异均有统计学意义(P<0.05)。患者DCI置入术前后各节段ROM比较,差异均无统计学意义(P>0.05)。患者DCI置入术后末次随访侧位Cobb角[(8.52±4.25)°]较术前[(3.71±4.53)°]增加,差异有统计学意义(P<0.05)。结论 DCI置入术治疗颈椎病的短期疗效较好,但其导致"前缘吸收,后缘增生"的现象,需要进一步的研究来观察。更多还原

【Abstract】 Objective To observe the early effect and postoperative improvement situation of dynamic cervical implant(DCI) in the treatment of cervical spondylosis and to investigate its clinical effect and influence on postoperative changes. Methods 23 patients with cervical spondylosis conforming to the indication for DCI from October 2010 to April 2012 were followed up. All cases were performed the anterior discectomy,spinal decompression and DIC operaions. The Visual Analogue Scale(VAS),spinal cord function evaluation by the Japanese Orthopedics Association(JOA) and Neck Disability Index(NDI) were used to assess the symptoms alleviation and functional recovery situation before and after operation. The Cobb angle in the opera-tive segment and upper and lower adjacent segments were measured,furthermore the range of motion(ROM) in these segments were calculated. Results All patients were followed up for 8-18 months with an average of(14.5±3.5)months. The JOA functional score at last follow up after DCI operation was(15.2±3.1) points,VAS score was(2.8±2.4) points and NDI score was(18.3±2.2)points,which before operation were(8.3±1.1),(8.0±0.6),(40.1±1.6) points respectively,showing the statistically significances between before and after operation(P<0.05). ROM at each segment had no statistical differences between before and after DCI op-eration(P>0.05). The lateral Cobb angle at last follow up after DCI operation was significantly increased compared with before op-eration[(8.52±4.25)° vs.(3.71±4.53)°],the difference was statistically significant(P<0.05). Conclusion DCI operation for treating cervical spondylosis can got better short-term effect,but its leading the phenomenon of anterior edge absorption and posterior edge hyperplasia needs to be observed through further researches.更多还原