Clinical Research On Cervical Arthroplasty

Objection To investigate early clinical effects and indication of Bryan cervical disc prosthesis in treatment of radiculopathy or spondylotic myelopathy.Method From 2004.11 to 2005.7, Bryan disc replacement applied in 19 cases(25 levels). Among these cases, there are cervical spondylotic myelopathy 15 cases, cervical spondylotic radiculopathy 4 cases. Clinical (JOA score and Odom's scales) and radiological (X-ray of bending, extending position) follow-up were performed 1 months postoperatively in all cases. Radiographic study about stability of prosthesis and range of motion(ROM) of replaced level post operationally were measured.Result At least 3 month follow-up were done in all these patients. JOA score increased from average 9.2(7–12) to 15.4(14–16) in those patients of cervical spondylotic myelopathy. According Odom'scale, excellent 16, good 2, fair 1, poor 0. Replaced segment restored partial of normal ROM7.52°(3.4°–12.1°) in single-level group, 6.95°(3.0°–10.8°) in bi-level group. No obvious instability or subsidence was found.Conclusion Bryan cervical disc replacement can achieve good anterior decompression treatment effect. At the same time, it restored partial motion to the level of the intact segment in flexion-extension postoperatively and stability in replaced 1 or 2 levels. It is deemed an effective, new way for the treatment of cervical spondylosis. Objective To investigate the mechanism that no intervertebral disc degeneration heavier at segment adjacent in the application of cervical arthroplasty.Method Cervical disc prosthesis replacement applied in 15 cases(21 levels), anterior cervical arthrodesis applied in 15 cases. All the patients had cervical spondylosis. X-rays examination of bending , extending; left and right bending position were carried out preoperatively and 3 months postoperatively. Range of movement(ROM) at segments adjacent were measured.Result There was no significant difference(P>0.05) between the two groups preoperatively. ROM of group of replacement was less than that of the other group 3 months postoperatively. There was significant differenc(eP<0.01). In group replacement, ROM before operation and ROM after operation have no significant difference.(P>0.05). Conclusions It will not appear that degeneration accelerate at segment adjacent in the application of cervical intervertebral disc replacement.