• 1 濰坊醫(yī)學(xué)院附屬醫(yī)院脊柱外科（山東濰坊，261031）;;
  • 2 北京大學(xué)第三醫(yī)院骨科;

目的 評估單節(jié)段Bryan 人工頸椎間盤置換術(shù)后異位骨化發(fā)生情況，分析異位骨化對術(shù)后療效影響。 方法 回顧分析2005 年10 月－ 2007 年10 月48 例行單節(jié)段Bryan 人工頸椎間盤置換術(shù)患者臨床資料。男27 例，女21 例；年齡33 ～ 51 歲，平均40.5 歲。脊髓型頸椎病8 例，神經(jīng)根型頸椎病27 例，混合型頸椎病13 例。病程2 ～ 14個月，平均10.3 個月。病變節(jié)段：C3、4 3 例，C4、5 6 例，C5、6 30 例，C6、7 9 例。術(shù)后采用疼痛視覺模擬評分（VAS）、頸椎功能障礙指數(shù)（NDI）、置換節(jié)段活動度評價療效；并將患者按術(shù)后是否發(fā)生異位骨化分為兩組，比較術(shù)后1、2、3、4 年以上各指標差異。 結(jié)果 患者術(shù)中及術(shù)后均無嚴重并發(fā)癥發(fā)生。48 例均獲隨訪，隨訪時間48 ～ 72 個月，平均56.6 個月。術(shù)后各時間點VAS 評分及NDI 均較術(shù)前顯著改善（P  lt; 0.05）；除術(shù)后3 d，其余各時間點置換節(jié)段活動度與術(shù)前比較差異均無統(tǒng)計學(xué)意義（P  gt; 0.05）。術(shù)后4 年共13 例（27.08%）發(fā)生異位骨化，其中1 級8 例，2 級3 例，3 級2 例。異位骨化組和無異位骨化組患者術(shù)后各時間點置換節(jié)段活動度及VAS 評分、NDI 比較，差異均無統(tǒng)計學(xué)意義（P  gt; 0.05）。 結(jié)論 單節(jié)段Bryan 人工頸椎間盤置換術(shù)后異位骨化發(fā)生率相對較高，異位骨化對人工頸椎間盤置換節(jié)段活動度影響較小，對術(shù)后療效無明顯影響。

引用本文： 劉文華,朱兵,劉曉偉,孫宇. 單節(jié)段Bryan 人工頸椎間盤置換術(shù)后異位骨化的發(fā)生率和療效觀察. 中國修復(fù)重建外科雜志, 2012, 26(6): 699-702. doi: 復(fù)制

1.
2.
3. Bertagnoli R, Duggal N, Pickett GE, et al. Cervical total disc replacement, part two: clinical results. Orthop Clin North Am, 2005, 36(3): 355-362.
4. Porchet F, Metcalf NH. Clinical outcomes with the Prestige II cervical disc: preliminary results from a prospective randomized clinical trial. Neurosurg Focus, 2004, 17(3): E6.
5. Toyoda T, Matsumoto H, Tsuji T, et al. Heterotopic ossification after total knee arthroplasty. J Arthroplasty, 2003, 18(8): 760-764.
6. McAfee PC, Cunningham BW, Devine J, et al. Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech, 2003, 16(4): 384-389.
7. Mehren C, Suchomel P, Grochulla F, et al. Heterotopic ossification in total cervical artificial disc replacement. Spine (Phila Pa 1976), 2006, 31(24): 2802-2806.
8. 劉忠軍. 脊柱外科手術(shù)操作與技術(shù). 北京: 人民衛(wèi)生出版社, 2009: 26-27.
9. 周非非, 趙衍斌, 孫宇, 等. Bryan人工頸椎間盤置換術(shù)后異位骨化形成的臨床因素分析. 中國脊柱脊髓雜志, 2009, 19(1): 39-43.
10. Goffin J, van Calenbergh F, van Loon J, et al. Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level. Spine (Phila Pa 1976), 2003, 28(24): 2673-2678.
11. Wigfield C, Gill S, Nelson R, et al. Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease. J Neurosurg, 2002, 96(1 Suppl): 17-21.
12. 田偉, 劉波, 李勤, 等. Bryan人工頸椎間盤置換對頸椎功能影響的臨床分析. 中華外科雜志, 2008, 46(5): 338-341.
13. 楊大龍, 申勇, 曹俊明, 等. 頸人工椎間盤置換近期并發(fā)癥分析. 中國脊柱脊髓雜志, 2008, 18(4): 249-252.
14. Leung C, Casey AT, Goffin J, et al. Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery, 2005, 57(6): 759-763.
15. 孫宇, 潘勝發(fā), 張鳳山, 等. Bryan人工椎間盤置換術(shù)治療頸椎病的近期臨床效果及出現(xiàn)的問題. 中國脊柱脊髓雜志, 2008, 18(1): 13-17.
16. Botelho RV, Moraes OJ, Fernandes GA, et al. A systematic review of randomized trials on the effect of cervical disc arthroplasty on reducing adjacent-level degeneration. Neurosurg Focus, 2010, 28(6): E5.
17. Lee JH, Jung TG, Kim HS, et al. Analysis of the incidence and clinical effect of the heterotopic ossification in a single-level cervical artificial disc replacement. Spine J, 2010, 10(8): 676-682.
18. Kim SW, Limson MA, Kim SB, et al. Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J, 2009, 18(2): 218-231.
19. Du J, Li M, Liu H, et al. Early follow-up outcomes after treatment of degenerative disc disease with the discover cervical disc prosthesis. Spine J, 2011, 11(4): 281-289.
20. Sasso RC, Snmcker JD, Haeker RJ, et al. Artificial disc versus fusion: a prospective, randomized study with 2-year follow-up on 99 patients. Spine (Phila Pa 1976), 2007, 32(26): 2933-2942．.
21. Kim SW, Paik SH, Castro PA, et al. Analysis of factors that may influence range of motion after cervical disc arthroplasty. Spine J, 2010, 10(8): 683-688.
22. Zechmeister I, Winkler R, Mad P. Artifi cial total disc replacement versusfusion for the cervical spine: a systematic review. Eur Spine J, 2011, 20(2): 177-184.
  1. 1.
  2. 2.
  3. 3. Bertagnoli R, Duggal N, Pickett GE, et al. Cervical total disc replacement, part two: clinical results. Orthop Clin North Am, 2005, 36(3): 355-362.
  4. 4. Porchet F, Metcalf NH. Clinical outcomes with the Prestige II cervical disc: preliminary results from a prospective randomized clinical trial. Neurosurg Focus, 2004, 17(3): E6.
  5. 5. Toyoda T, Matsumoto H, Tsuji T, et al. Heterotopic ossification after total knee arthroplasty. J Arthroplasty, 2003, 18(8): 760-764.
  6. 6. McAfee PC, Cunningham BW, Devine J, et al. Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech, 2003, 16(4): 384-389.
  7. 7. Mehren C, Suchomel P, Grochulla F, et al. Heterotopic ossification in total cervical artificial disc replacement. Spine (Phila Pa 1976), 2006, 31(24): 2802-2806.
  8. 8. 劉忠軍. 脊柱外科手術(shù)操作與技術(shù). 北京: 人民衛(wèi)生出版社, 2009: 26-27.
  9. 9. 周非非, 趙衍斌, 孫宇, 等. Bryan人工頸椎間盤置換術(shù)后異位骨化形成的臨床因素分析. 中國脊柱脊髓雜志, 2009, 19(1): 39-43.
  10. 10. Goffin J, van Calenbergh F, van Loon J, et al. Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level. Spine (Phila Pa 1976), 2003, 28(24): 2673-2678.
  11. 11. Wigfield C, Gill S, Nelson R, et al. Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease. J Neurosurg, 2002, 96(1 Suppl): 17-21.
  12. 12. 田偉, 劉波, 李勤, 等. Bryan人工頸椎間盤置換對頸椎功能影響的臨床分析. 中華外科雜志, 2008, 46(5): 338-341.
  13. 13. 楊大龍, 申勇, 曹俊明, 等. 頸人工椎間盤置換近期并發(fā)癥分析. 中國脊柱脊髓雜志, 2008, 18(4): 249-252.
  14. 14. Leung C, Casey AT, Goffin J, et al. Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery, 2005, 57(6): 759-763.
  15. 15. 孫宇, 潘勝發(fā), 張鳳山, 等. Bryan人工椎間盤置換術(shù)治療頸椎病的近期臨床效果及出現(xiàn)的問題. 中國脊柱脊髓雜志, 2008, 18(1): 13-17.
  16. 16. Botelho RV, Moraes OJ, Fernandes GA, et al. A systematic review of randomized trials on the effect of cervical disc arthroplasty on reducing adjacent-level degeneration. Neurosurg Focus, 2010, 28(6): E5.
  17. 17. Lee JH, Jung TG, Kim HS, et al. Analysis of the incidence and clinical effect of the heterotopic ossification in a single-level cervical artificial disc replacement. Spine J, 2010, 10(8): 676-682.
  18. 18. Kim SW, Limson MA, Kim SB, et al. Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J, 2009, 18(2): 218-231.
  19. 19. Du J, Li M, Liu H, et al. Early follow-up outcomes after treatment of degenerative disc disease with the discover cervical disc prosthesis. Spine J, 2011, 11(4): 281-289.
  20. 20. Sasso RC, Snmcker JD, Haeker RJ, et al. Artificial disc versus fusion: a prospective, randomized study with 2-year follow-up on 99 patients. Spine (Phila Pa 1976), 2007, 32(26): 2933-2942．.
  21. 21. Kim SW, Paik SH, Castro PA, et al. Analysis of factors that may influence range of motion after cervical disc arthroplasty. Spine J, 2010, 10(8): 683-688.
  22. 22. Zechmeister I, Winkler R, Mad P. Artifi cial total disc replacement versusfusion for the cervical spine: a systematic review. Eur Spine J, 2011, 20(2): 177-184.