Early efficacy of three dimensional printed anatomical biomimetic cervical artificial disc replacement in the treatment of cervical degenerative diseases / 中华外科杂志

Objective: To investigate the efficacy and safety of a new cervical artificial disc prosthesis in the treatment of cervical degenerative diseases. Methods: The clinical data of 18 patients with single-level cervical degenerative diseases who underwent three dimensional printed anatomical bionic cervical disc replacement at Department of Spinal Surgery,Honghui Hospital,Xi'an Jiaotong University from May 2019 to July 2020 were analyzed retrospectively. There were 7 males and 11 females,aged (45±8) years old(range:28 to 58 years).The surgical segment was located at C3－4 level in 2 cases, C4－5 level in 5 cases, C5－6 level in 9 cases, and C6－7 level in 2 cases.The clinical and radiographic outcomes were recorded and compared at preoperative,postoperative times of one month and twelve months.The clinical assessments contained Japanese orthopedic association (JOA) score,neck disability index (NDI) and visual analogue scale (VAS).Imaging assessments included range of motion (ROM) of cervical spine, prosthesis subsidence and prosthesis anteroposterior migration.Repeated measurement variance analysis was used for comparison between groups,and paired t test was used for pairwise comparison. Results: All patients underwent the operation successfully and were followed up for more than 12 months.Compared with preoperative score,the JOA score,NDI and VAS were significantly improved after surgery (all P<0.01).There was no significant difference in postoperative ROM compared with 1-and 12-month preoperative ROM (t=1.570,P=0.135;t=1.744,P=0.099). The prosthesis subsidence was (0.29±0.13) mm (range: 0.18 to 0.50 mm) at 12-month postoperatively.The migration of prosthesis at 12-months postoperatively were (0.71±0.20) mm (range: 0.44 to 1.08 mm).There was no prosthesis subsidence or migration>2 mm at 12-month postoperatively. Conclusion: Three dimensional printed anatomical biomimetic cervical artificial disc replacement has a good early clinical effect in the treatment of cervical degenerative diseases, good mobility can be obtained while maintaining stability.

Characteristic and surgical treatment of cervicothoracic spine fracture / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the clinical characteristic and surgical treatment of cervicothoracic spine fracture complicated with spine cord injury.</p><p><b>METHODS</b>Thirty-eight patients with cervicothoracic fracture and spine cord injury were retrospectively analyzed from January 1998 to January 2007. There were 29 males and 9 females with an average age of 36.4 years ranging from 18 to 58 years. All patient suffered from pain and limitation of motion on cervicothoracic junction. According to American Spinal Injury Association (ASIA) grades, 4 cases were in grade A, 13 cases in grade B, 10 cases in grade C, 7 cases in grade D and 4 cases in grade E. All patients were treated with anterior decompressed, bone graft and Zephir plate fixation in cervicothoracic spine.</p><p><b>RESULTS</b>All patients were followed up for 1 to 10 years, the mean followed up time was 4.5 years. And all patients got complete bone fusion within 4 to 6 months postoperatively. There were no pull-out and breakage of screws or plates. Spinal cord functional recovery improved on average 3.8 degree according AISA standard. Two patients appeared transient hoarse voice after surgery, the symptoms were alleviated from 3 to 6 months after operation. Seven patients were complicated with Horner syndrome preoperatively, and the symptoms were disappeared after operation.</p><p><b>CONCLUSION</b>The clinical situation of cervicothoracic spine fracture with spine cord injury is complicated. And anterior decompressed, bone graft and internal fixation performed on cervicothoracic spine fracture can achieve an efficient and safe clinical outcome.</p>