Bryan颈椎间盘假体置换治疗硬膜外型颈椎间盘突出症

目的探讨Bryan人工颈椎间盘置换应用于硬膜外型颈椎间盘突出症的手术技巧并评价其近期临床疗效。方法2005年2月~2005年12月,对5例硬膜外型颈椎间盘突出症患者实施前路减压 Bryan颈椎间盘假体置换术。术前摄颈椎正、侧位和动力位X线片,颈椎CT、MRI并进行颈椎病JOA评分。术后1周复查颈椎X线片以了解假体位置及其活动功能情况;复查颈椎MRI,了解颈段脊髓减压情况。本组病例均获随访3~13个月(平均7个月),分别于术后6周、3个月重新进行JOA评分。结果本组患者均完成单节段椎间盘置换,术后无神经、血管损伤等并发症发生;颈椎MRI示所有患者颈脊髓减压彻底,术后临床症状均显著改善;术后6周及3个月的JOA评分较术前有明显提高。至最后一次随访复查,手术节段活动度无明显丢失,假体均无偏移、下沉等。结论对硬膜外型颈椎间盘突出症行Bryan颈椎间盘假体置换术时,在满足假体骨床的前提下,仍可获得充分的颈脊髓减压。

Cervical arthroplasty with Bryan disc prosthesis for the treatment of epidural cervical disc extrusion

Objective To explore the surgical technique in the treatment of epidural cervical disc extrusion (ECDE) using Bryan cervical disc prosthesis and to evaluate its clinical effect in the near future. Methods From February 2005 to December 2005, five patients of ECDE were treated by anterior decompression plus single-level Bryan disc prosthesis replacement. Radiological examinations (X-ray, CT, MRI) and JOA grading were done before surgery. All the cases were followed up for at least 3 months (range 3-13 months, mean 7 months ) and JOA score was respectively regraded 6 weeks and 3 months after operation. Results There was no complication such as nerve injury or blood vessel injury and the spinal cord was decompressed completely on postoperative imaging in all cases. The artificial disc prosthesis implanted worked well in all cases. The 6th-week and 3rd-month postoperative JOA scores improved greatly compared to the preoperative. Conclusion The technique of Bryan disc prosthesis replacement for epidural cervical disc extrusion can also obtain complete decompression of spinal cord with the precondition of enough bony bed for the prosthesis.