Clinical Efficacy And Imaging Analysis Of Bryan Artificial Cervical Disc Replacement

Objective:To study the long-term efficacy of artificial cervical disc replacement in treating cervical spondylosis,and its effects on cervical lordosis,functional spinal unit curvature,replacement and adjacent segment activity,functional spinal unit activity and the adjacent segment degeneration,by collecting and evaluating the clinical indicators of Bryan artificial cervical disc replacement,measuring and analysising the postoperative imaging data.Methods:By retrospective studying the 29 patients(16 cases were male,13 cases were female,the average age was 48.5 years old,including 11 cases of nerve root type,12 cases of myelopathic type,6 cases of mixed type,39 cases of segmental lesions and19 cases of single segment replacement in total,10 cases of double segments replacement),who took the prosthesis implantation therapy of Bryan artificial cervical disc replacement in Dongzhimen Hospital of Beijing University of Chinese Medicine from 2011.08 to 2012.08.We collected the clinical data and postoperative imaging data at the early postoperative follow-up(1,3,and 6 months after the treatment)and long-term follow-up(12,24,36 months after the treatment).Assessing the clinical efficacy and improvement of neurological function with Odom,VAS,JOA and NDI scoring system.Analyzing the cervical lordosis,functional spinal unit curvature,replacement and adjacent segment activity,functional spinal unit activity and the incidence of adjacent segment degeneration by measuring the imaging data.SPSS 18.0 software was used for statistical analysis.Results:After 36 months follow-up,the Odom rating was 96.55%,before and after the operation 36 months follow-up,the VAS scores were(7.26±1.45)and(2.15±0.72),JOA scoreswere(8.9±2.11)and(15.0±1.29),NDI scores were(38.10±7.09)and(27.79±7.12),the postoperative JOA,VAS and NDI scores were all significantly improved compared with preoperative,statistical analysis showed significant differences(p<0.05);lordosis and functional spinal unit cervical curvature increased significantly compared with the preoperative,those who cervical vertebra lordosis and functional spinal unit curvature decrease or disappear before the operation got improved,preoperative and postoperative follow-up results,statistical analysis showed significant differences(p<0.05);and the early and late follow-up resultsshowed significant differences(p<0.05).The early postoperative follow-up showed that the activity of cervical spine,the displacement of the segment,the activity of the adjacent segment,and the activity of the spinal functional units were lower than those before operation,and the difference was statistically significant.However,after 12-36 months of follow-up,the activity can be restored to the preoperative level,and there was no significant difference compared with preoperative.After 36 months,the incidence of adjacent segment degeneration was 10.34%.Conclusion:Bryan artificial cervical disc replacement not only has good long-term clinical efficacy,but also reconstruct the cervical spine function unit of the lordotic curvature,restore the function of cervical biomechanics,retain overall cervical movement function,reduce the incidence of adjacent segment degeneration.Artificial cervical disc replacement represents a new concept of non fusion,it still needs a large multicenter comparative clinical study and long-term follow-up,we believe its clinical application will be more extensive.