假体和植入物；_椎间盘_腰椎；_椎间盘移位；

人工腰椎间盘置换后椎间隙高度变化

http://www.100md.com 《福建医科大学学报》 2006年第5期

假体和植入物；,椎间盘,腰椎；,椎间盘移位；,外科手术；,治疗结果,,假体和植入物；,椎间盘，腰椎；,椎间盘移位；,外科手术；,治疗结果,1对象与方法,2结果

     摘要: 目的观察人工椎间盘置换对维持腰椎间隙高度的作用，探讨人工椎间盘置换术减缓腰腿痛的作用机制。方法对20例患者29个节段进行SB Charite Ⅲ型人工椎间盘置换术，于手术前后及随访期间按Mochida’s法测量手术节段及手术相邻节段椎间隙高度，计算椎间隙高度(a)与上位椎体高度(A)的比值(R=a/A)；并对患者临床临床表现进行JOA评分。结果平均JOA评分从术前的(10.80±3.81)分提高到术后的(20.90±2.45)分，经(14.0±6.1)月(6~27月)随访，评分为(25.95±2.01)分，各个期间评分比较差别有统计学意义(P<0.001)。置换节段的R值在术前为(0.366±0.053)，术后为(0.524±0.048)，随访时为(0.527±0.046)；与术前比较，术后及随访时的R值均有明显上升(P<0.001)，而术后与随访期间的R值比较差别无统计学意义(P>0.05)。相邻节段在术前、术后及随访期间的R值分别为(0.445±0.076)、(0.461±0.068)和(0.450±0.054)，三者比较无统计学意义(P>0.05)。结论SB Charite Ⅲ型人工椎间盘置换术能有效地恢复置换节段椎间隙高度，对相邻节段椎间隙高度无明显影响；经过随访，椎间隙高度的恢复无明显丢失。

    关键词: 假体和植入物；椎间盘，腰椎；椎间盘移位；外科手术；治疗结果

    Effects of SB Charite Ⅲ Prosthesis Replacement

    on Height of Intervertebral Disc Space

    Lin Feiyue, Li Kanghua, Lei Guanghua, Lin Zhangyuan, Yin Xiaoming

    1.Department of Orthopedic, Xiangya Hospital, Central South University, Changsha 410008, China

    2.Department of Orthopedic, Fujian Provincial Hospital, Fuzhou 350001, China

    ABSTRACT: Objective To determine the effects of SB Charite Ⅲ prosthesis replacement on the height of intervertebral disc space. Methods Twentynine protruded lumbar intertebral discs from twenty patients were replaced with SB Charite Ⅲ prosthesis. The lumbar spine Xray images of these patients were studied; the heights of operated and adjacent disc spaces were measured with Mochida’s method at preoperation, postoperation and during followup. The clinical results were evaluated with scoring system of the Japanese Orthopedic Association for low back pain(JOA Score) preand postoperation and during followup. The average followup time was (14.0±6.1) months (6～27 months). ResultsThe average JOA scores at preoperation, postoperation and followup were (10.80±3.81), (20.90±2.45) and (25.95±2.01), respectively(P<0.001). The Mochida'method R values of operated segments at preoperation, postoperation and during followup were (0.366±0.053), (0.524±0.048) and (0.527±0.046), respectively. The R value increased significantly at postoperation and followingup(P<0.001), comparing with which at preoperation. However, the R values between which at postoperation and followup had no significant different(P=0.902). The R values of adjacent segments at preoperation, postoperation and followingup were(0.445±0.076), (0.461±0.068) and (0.450±0.054), respectively, and there had no significant different among these R values (P>0.05). Conclusion SB Charite Ⅲ prosthesis replacement in patients suffering from LDH can relax the sciatica and restore the disc space height. ......

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