Effect of preoperative segmental range of motion on patient outcomes in cervical disc arthroplasty
Effect of preoperative segmental range of motion on patient outcomes in cervical disc arthroplasty
复制标题
颈椎间盘置换术术前节段活动度对患者预后的影响
DOI：
10.1186/s12891-020-03419-7
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发表时间：
2020-07-13
影响因子：
2.3
通讯作者：
Wang, Bei-yu
中科院分区：
文献类型：
--
作者：
Wu, Ting-kui;Liu, Hao;Wang, Bei-yu
背景颈椎间盘成形术（CDA）在临床试验中已被证明是诊断为神经根病和/或脊髓病的患者的有效和安全的治疗方法。然而，基于术前节段性活动度（ROM）的当前CDA适应症标准包含了广泛的可变性。虽然关节置换术水平保留ROM平均7度-9度后CDA，有没有明确的指导方针术前有限或过度的ROM在索引级别，这可能被认为是适合CDA.MethodsThis是一项回顾性研究的患者谁接受CDA之间2008年1月和2018年10月在我们医院使用Prestige-LP光盘。根据术前指数级ROM将患者分为小ROM（12.5度）组。评价临床结局，包括日本骨科协会（乔亚）、颈部残疾指数（NDI）和视觉疼痛量表（VAS）评分。影像学参数，包括颈椎前凸，椎间盘角度（DA），全球和节段ROM，椎间盘高度（DH），和并发症进行了measured.Results126例，共132关节置换节段进行了分析。小ROM组有64例患者，大ROM组有62例患者。小ROM组中诊断为颈椎病的患者多于大ROM组（P =0.046）。两组患者术后乔亚、NDI和VAS评分均显著改善，但组间差异不显著。小ROM组患者术后颈椎前凸、整体和节段ROM显著增加（P
BackgroundCervical disc arthroplasty (CDA) has been demonstrated, in clinical trials, as an effective and safe treatment for patients diagnosed with radiculopathy and/or myelopathy. However, the current CDA indication criteria, based on the preoperative segmental range of motion (ROM), comprises a wide range of variability. Although the arthroplasty level preserved ROM averages 7 degrees -9 degrees after CDA, there are no clear guidelines on preoperatively limited or excessive ROM at the index level, which could be considered as suitable for CDA.MethodsThis was a retrospective study of patients who underwent CDA between January 2008 and October 2018 using Prestige-LP discs in our hospital. They were divided into the small-ROM (12.5 degrees) groups according to preoperatively index-level ROM. Clinical outcomes, including the Japanese Orthopedics Association (JOA), Neck Disability Index (NDI), and Visual Analogue Scale (VAS) scores, were evaluated. Radiological parameters, including cervical lordosis, disc angle (DA), global and segmental ROM, disc height (DH), and complications were measured.ResultsOne hundred and twenty six patients, with a total of 132 arthroplasty segments were analyzed. There were 64 patients in the small-ROM and 62 in the large-ROM group. There were more patients diagnosed with cervical spondylosis in the small-ROM than in the large-ROM group (P =0.046). Patients in both groups had significantly improved JOA, NDI, and VAS scores after surgery, but the intergroup difference was not significant. Patients in the small-ROM group had dramatic postoperative increase in cervical lordosis, global and segmental ROM (P