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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Artificial disc insertion following anterior cervical discectomy.
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Artificial disc insertion following anterior cervical discectomy.

机译：颈前路椎间盘切除术后人工椎间盘插入。

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OBJECTIVE AND IMPORTANCE: Fusion following anterior cervical discectomy has been implicated in the acceleration of degenerative changes in the adjacent spinal segments. Discectomy followed by implantation of an artificial cervical disc maintains the functionality of the spinal unit, while still providing excellent symptomatic relief. We describe our preliminary experience with implantation of the Bryan Cervical Disc System in two cases of single-level cervical disc herniation. CLINICAL PRESENTATION: Two male patients presented with a left C6 radiculopathy, without evidence of myelopathy. Magnetic resonance imaging revealed a disc herniation at C5-6 in both cases. Pre-operative flexion and extension radiographs demonstrated preserved motion at the involved levels. INTERVENTION/TECHNIQUE: Following a standard anterior cervical decompression, precision drilling of the vertebral endplates was carried out using a drill attached to a bed-mounted, gravitationally-referenced retraction frame. An artificial cervical disc, composed of a polyurethane nucleus with titanium endplates, was fitted between the contoured endplates without fixation to the vertebral bodies. No complications were experienced during the insertion of the prosthesis, or in the postoperative course. Both patients experienced immediate postoperative resolution of their radicular pain and were discharged from hospital the following day. At nine months following surgery, both patients continue to have complete relief of radicular symptoms. Postoperative radiographs at six months following surgery confirm accurate placement of the prosthesis and preserved mobility of the functional spinal unit. CONCLUSION: Insertion of the Bryan artificial cervical disc prosthesis following anterior cervical discectomy is a relatively straightforward procedure, which appears to be safe and provides good clinical results, without requiring additional surgical time. Long-term follow-up is required to assess its safety, efficacy, and ability to prevent adjacent segment degeneration.
机译：目的和意义：颈椎前路椎间盘切除术后融合术与邻近脊柱节段退行性变化的加速有关。椎间盘切除术然后植入人工颈椎盘可保持脊柱单元的功能，同时仍可提供出色的症状缓解。我们描述了在两个单级颈椎间盘突出症病例中植入Bryan颈椎间盘系统的初步经验。临床表现：两名男性患者出现左C6神经根病，无脊髓病迹象。两种情况下，磁共振成像均显示椎间盘突出在C5-6处。术前屈曲和伸展X线片显示在所涉及的水平上运动得以保留。干预/技术：在进行标准的颈椎前路减压之后，使用附接到床架上的，以重力为参考的回缩架上的钻头对椎骨终板进行精确钻孔。人造颈椎间盘由聚氨酯核和钛终板组成，安装在异形终板之间，而没有固定在椎体上。假体插入过程中或术后过程中均未发生并发症。两名患者术后均立即消除了其根部疼痛，并于第二天出院。手术后九个月，两名患者继续完全缓解神经根症状。手术后六个月的术后X线照片证实了假体的正确放置并保留了功能性脊柱单元的活动性。结论：颈前路椎间盘切除术后插入Bryan人工颈椎间盘假体是相对简单的过程，似乎安全且可提供良好的临床效果，而无需额外的手术时间。需要进行长期随访，以评估其安全性，有效性以及预防相邻节段变性的能力。

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