Discover人工颈椎间盘置换术后异位骨化的临床研究
梁英杰,张光明,温世锋,郭东明,徐中和,刘恩志,钟润泉,肖文德,尹庆水
中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (3) : 336-340.
Discover人工颈椎间盘置换术后异位骨化的临床研究
Clinical observation of heterotopic ossification after Discover cervical disc replacement
目的 分析Discover人工颈椎间盘置换术治疗颈椎病的异位骨化形成原因及防治对策。 方法 回顾性分析23例应用Discover人工颈椎间盘置换术治疗的颈椎病患者。 在术前、术后1周及末次随访时的颈椎X线片上测量置换节段矢状位、冠状位活动度，并根据McAfee分级法判断末次随访时置换节段的异位骨化情况。 结果 术后患者23例患者均获随访，时间27~36个月。末次随访置换节段矢状位活动范围（5.5±2.2）°；冠状位左右侧屈活动范围分别为（3.4±1.2）°和（3.6 ±0.8）°。共有5例患者在末次随访时出现置换节段假体周围异位骨化，发生率21.7%。 结论 DISCOVER人工颈椎间盘置换术治疗颈椎病存在一定的异位骨化发生率，与文献报道相符，术者应有意识地预防异位骨化的发生以避免置换节段的活动度丢失。
Objective To analyze the cause of heterotopic ossification of Discover artificial cervical disc replacement in the treatment of cervical vertebra disease and to explore preventive countermeasures. Methods We retrospectively reviewed radiographic and clinical outcomes in 23 patients who received the Discover cervical disc prosthesis. Static and dynamic X ray was taken for measurement of the range of motion. Replacement segment was assessed for heterotopic ossifications at the latest follow-up according to McAfee classification method. Results 23 patients were followed up for 27~36 months. In the last follow-up, the average sagittal range of motion was 5.5°±2.2°，and the average coronal range of motion was 3.4°±1.2° and 3.6°±0.8°. A total of 5 patientsdemonstrated the prosthesis replacement segmental heterotopic ossification at the last follow-up, the incidence being 21.7%. Conclusions heterotopic ossification can occur after DISCOVER artificial cervical disc replacement in the treatment of cervical spondylosis; the incidence is consistent with the literature report; the surgeon should try consciously to prevent the occurrence of heterotopic ossification in order to avoid the loss of the mobility of the replacement segment.
Cervical spondylosis / Artificial intervertebral disc / Heterotopic ossification
[1] 袁文．颈椎固定融合存在的问题和进展[J]．中国脊柱脊髓杂志，2002，12：327．
[2] 吴李闯，何齐芳，王 伟，等.颈椎动态稳定器置入治疗颈椎病近期临床疗效[J].临床骨科杂志，2012,15（6）：615-617.
[3] Mehren C．Mayer HM．Artifical cervical disc replacement and update[J]．Neurol India，2005，53(4)：440-444．
[4] Nabhan A，Ahlhelm F，Shariat K，et a1．The ProDiscisc prothesis clinical and radiological experience 1 year after surgery[J]．Spine，2007，32(8)：1935-1941．
[5] McAfee PC．The indications for lumbar and cervical disc replacement[J]．Spine J，2004，4(6 Suppl)：177-181．
[6] Mununaneni PV．Robinson JC．Jr Haid RW．Cervical arthroplasty with the Prestige LP cervical disc [J]. Neurosurgery,2007,60(4 Suppl 2)：310-314．
[7] Kang KC，Lee CS，Han JH，et al．The factors that influence the postoperative segmental range of motion after cervical artificial disc replacement[J]．Spine J，2010，10(8)：689-696．
[8] Auerbach JD，Jones KJ．Fras CI，el a1．The prevalence of indications and contraindications to cervical total disc replacement[J]．Spine J，2008,8(5):711-716．
[9] Peng CW．Quimoa M，Bendn JA，et a1．Effect of intervertebral disc height on postoperative motion and clinical outcomes after Prodisc-C cervical disc replacement[J]．Spine J，2009,9(7)：551-555．
[10]Kim SW, Paik SH，Castro PA，et a1．Analysis of factors that may influence range of motion after cervical disc arthroplasty[J]．Spine J，2010，10(8)：683-688．
[11]Barbagallo GM, Assietti R, Corbino L, et a1．Early results and review of the literature of a novel hybrid surgical technique combining cervical arthrodesis and disc arthroplasty for treating multilevel degenerative disc disease：opposite or complementary techniques[J]Euro Spine J，2009，18(1)：29-39.
[12]McAfee PC，Cunningham BW，Devine J，et a1．Classification of heterotopic ossification(HO) in artificial disk replacement[J]．J Spinal Disord Tech，2003，16(4)：384-389．
[13] Sasso RC，Smucker JD，Hacker RJ，et al．Artificial disc versus fusion：a prospective。randomized study with 2-year follow—up on 99 patients[J]．Spine(Phila Pa 1976)，2007，32(26)：2933-2940．
[14]Mummaneni PV，Burkus JK，Haid RW，et al．Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion：a randomized controlled clinical trial[J]．J Neurosurg Spine，2007，6(3)：198-209．
[15]Dmitriev AE，Cunningham BW，Hu N，et al．Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty：an in vitro human cadaveric model[J]．Spine，2005，30(10)：1165-1172．
[16]Rousseau MA，Cottin P，Levante S，et al．In vivo kinematics of two types of ball-and-socket cervical disc replacements in the sagittal plane：cranial versus caudal geometric center[J]．Spine，2008，33(1)：E6-9．
[17]Anderson P A, Sasso R C, Riew K D. Comparison of adverse even between the Bryan artificial cervical disc and anterior cervical arthrodesis [J]. Spine, 2008, 33(12):1305-1312.
[18]Cao JM, Zhang YZ, Shen Y, et al. Complications of Bryan cervical disc replacement [J]. Orthop Surg, 2010,2(2):86-93.
[19]周非非，赵衍斌，孙宇, 等．单节段Bryan人工椎间盘置换术后异位骨化形成对置换节段活动度的影响[J]．脊柱外科杂志，2011，9(5)：279-282．
[20]Lee JH，Jung TG，Kim HS，et a1．Analysis of the incidence and clinical effect of the heterotopic ossification in a single—level cervical artificial disc replacement[J]．Spine J，2010，10(8)：676-682.
[21]Sola S，Hebecker R，Knoop M，et a1．Bryan cervical disc prosthesis three years follow-up[J]．Eur Spine J，2005，14(suppl 1)：S38．
[22]Leung C，Casey AT，Gofifin J，et a1．Clinical significance of heterotopic ossification in cervical disc replacement：a prospective multi-center clinical trial[J]．Neurosurgery，2005，57(4)：759-763．
[23]Mehren C，Suchomel P，Grochulla F，et a1．Heterotopic ossification in total cervical artificial disc replacement[J]．Spine，2006，3l(24)：2802-2806．
[24]杨大龙, 申 勇, 曹俊明, 等. 颈人工椎间盘置换近期并发症分析[J].中国脊柱脊髓杂志, 2008,18(4): 249-252.
广东省科技厅科技计划项目（2012B031800334）
京ICP备08002354号-3/
| 〈 |
|
〉 |
