| Objective: Recovery of nerve function through the study patients before and aftersurgery, Degree of pain relief, X-ray before and after surgery adjacent segmentdegeneration, Cobb angle changes and Vertebral activity, To evaluate the early effectsof cervical artificial disc replacement surgery.Methods: From January2010to December2011Travel single segment cervicalartificial disc replacement in the treatment patients with cervical screening hospitalizedpatients26cases. Male15cases, female11cases. Age32-60years, an average of46.81±7.3years old. Duration of1month-24months, an average of10.69±6.4months. Including18cases of cervical spondylotic myelopathy,5cases of nerve roottype cervical spondylosis, Mixed type of cervical disease in3cases (nerve root andspinal cord). C3/4section3patients, C4/58cases, C5/6in10cases, C6/7in5cases.Mobi-C prosthesis13cases, Prestige prosthesis8cases, Discover prosthesis five cases.Follow-up JOA grade postoperative recovery of neurological function Pre–surgery andAfter surgery. VAS pain rating evaluation of patients with pain relief. According to thepreoperative and postoperative1month,3months,6months,12months, X-rayexamination. Vertebral compared before and after surgery on two vertebrae Cobb anglechanges. Replaced segment activity comparison before and after surgery. Anddegenerative intervertebral space based on K-L (Kellgren) imaging classification,Observed adjacent segment degeneration. And then the evaluation of the line cervicaldisc replacement surgery on the adjacent vertebral bodies.Results: All patients completed by the same surgeon. The operation time of50-90minutes, with an average of68.85±13.2minutes.50-200ml of blood loss, an average of109.2±54.9ml.8days-15days, length of stay, average12.13±3.4days. Allpatients did not occur in the case of spinal cord injury and nerve root injury.Postoperative day1, either do not use the collar to get out of bed. Use of mannitoltreatment after1-3days.All patients with shoulder and neck and upper limb pain andnumbness symptoms were relieved. Incision in5-7days, stitches are healing phase I.Wound infection, hematoma, fistula and other complications did not occur. Drainagetubes were removed within24hours after the48hours(Removal of standard drainagewithin24hours and not less than10ml). Postoperative patients with cerebrospinalfluid,48hours after surgery to give patients drainage tubes were removed, Andstitching drainage tube mouth, Patients with good prognosis.26patients were followedup for a follow-up time of12months after surgery. The follow-up process, No stemsubsidence, heterotopic ossification and other postoperative complications. Patients bycomparing preoperative JOA score to9.41±3.06, Final follow-up JOA score was13.76±2.30.P<0.05, by the difference was statistically significant. Preoperative VAS painscore was4.81±2.04, Last follow-up for1.62±1.27,P<0.05, the difference wasstatistically significant. Postoperative replacement segment on the size of the next twosegments of the Cobb angle difference was no significant difference compared with thepreoperative, The results are P>0.05statistically meaningless. Activity before and afterthe replacement segment surgery was4.88±1.26, P>0.05, the difference was notstatistically significant. Degeneration classification based on K-L (Kellgren) imagingintervertebral space.3patients during follow-up degeneration,Three cases are0-1leveldegeneration of adjacent segment degeneration incidence of11.5%. The statisticalanalysis the degeneration from happening no statistically significant differences beforeand after surgery.Conclusion: Nerve function in patients before and after the situation has beensignificantly improved, Pain symptoms. The postoperative cervical stability nosignificant change. Replaced segment maintained a good activity. Cervical artificialdisc replacement surgery has played a certain protective effect on the adjacent segmentdisc. The efficacy of cervical artificial disc replacement in the treatment of cervicaldisease early is good. |
