Cervical Alignment After Cervical Arthroplasty with Prestige-LP Disc at C5-C6 Level
Cervical Alignment After Cervical Arthroplasty with Prestige-LP Disc at C5-C6 Level
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使用 Prestige-LP 椎间盘在 C5-C6 水平进行颈椎置换术后的颈椎对齐
DOI：
10.1016/j.wneu.2020.04.025
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发表时间：
2020-08-01
影响因子：
2
通讯作者：
Wang, Beiyu
中科院分区：
文献类型：
--
作者：
Rong, Xin;Hu, Xu;Wang, Beiyu
目的：探讨C5-C6节段Prestige-LP椎间盘植入对颈椎排列的影响以及颈椎排列与临床结果之间的关系。方法：连续回顾C5-C6节段颈椎间盘置换术的患者。采用日本骨科协会评分、颈部残疾指数、颈部疼痛视觉模拟量表（VAS）和手臂疼痛视觉模拟量表（VAS）来评估临床结果。测量运动范围 (ROM) 和颈椎排列，包括 C2-C7 角和 C5-C6 角。结果：纳入 77 名患者，平均随访时间为 42.6 个月。大多数患者的 VAS 评分和颈部残疾指数显着降低，但日本骨科协会评分显着增加。 C5-C6 ROM、C2-C7 ROM 和 C2-C7 角保留，C5-C6 角发生显着变化。 C2-C7角从术前的15.2度+/-11.5度显着增加到12个月随访时的19.4度+/-10.2度（P<0.001），并在最后一次随访时下降至16.8度+/-10.4度（P=0.45）。 C5-C6角度从术前的0.07度+/-5.2度显着增加到3个月随访时的2.8度+/-5.8度（P<0.001），并在最后一次测量时稳定在2.2度+/-5.8度（P=0.003）。 C2-C7 角度与临床结果之间没有发现显着相关性。 C5-C6角与手臂疼痛VAS评分存在显着相关性（r=-0.38；P=0.02）。结论：颈椎间盘置换术后C2-C7角得以保留，C5-C6角恢复前凸。节段性脊柱前凸似乎与较少的手臂疼痛有关。
OBJECTIVE: We explored the effects of implantation of the Prestige-LP disc at the C5-C6 level on cervical alignment and the association between the cervical alignment and clinical outcomes.METHODS: Patients with C5-C6 level cervical disc arthroplasty were consecutively reviewed. The Japanese Orthopaedic Association score, neck disability index, visual analog scale (VAS) for neck pain, and VAS for arm pain were used to evaluate the clinical outcomes. The range of motion (ROM) and cervical alignment, including the C2-C7 angle and C5-C6 angle, were measured.RESULTS: Seventy-seven patients were included, with a mean follow-up of 42.6 months. Most patients achieved a significant reduction in VAS scores and the neck disability index but had a significant increase in the Japanese Orthopaedic Association scores. The C5-C6 ROM, C2-C7 ROM, and C2-C7 angle were preserved and the C5-C6 angle had changed significantly. The C2-C7 angle increased significantly from 15.2 degrees +/- 11.5 degrees preoperatively to 19.4 degrees +/- 10.2 degrees at the 12-month follow-up visit (P < 0.001) and had decreased to 16.8 degrees +/- 10.4 degrees at the last follow-up visit (P = 0.45). The C5-C6 angle had increased significantly from 0.07 degrees +/- 5.2 degrees preoperatively to 2.8 degrees +/- 5.8 degrees at the 3-month follow-up visit (P < 0.001) and had stabilized at 2.2 degrees +/- 5.8 degrees at the last measurement (P = 0.003). No significant correlation was found between the C2-C7 angle and the clinical outcomes. A significant correlation was found between the C5-C6 angle and VAS score for arm pain (r = -0.38; P = 0.02).CONCLUSIONS: The C2-C7 angle was preserved and the C5-C6 angle was restored to lordosis after cervical disc arthroplasty. It seems that segmental lordosis was associated with less arm pain.