Early clinical effects of dynamic cervical implant in treatment of cervical disc herniation

Abstract

Objective To investigate the safety and early clinical efficiency of dynamic cervical implant (DCI) internal fixation to treat cervical disc herniation.Methods From September 2009 to December 2010,31 patients with herniation of cervical disc underwent DCI implantation.The operation time and blood loss were recorded and analyzed.Neck disability index (NDI),Japanese Orthopaedic Association (JOA) score,and visual analogue scale (VAS) score were used to evaluate neurofunctional recovery pre- and post-operation.Routinely,the patients accepted X-ray examination preoperatively and postoperatively.We used White's measurement to measure the range of motion(ROM) and height ratio of implant segment and the superior vertebra pre- and post-operation.Results The average operation time and amount of bleeding were 45 (30-60) min and (100±30) ml respectively.The average postoperative follow-up was 14 months (range,6-20).The average NDI (50.5±16.2 vs.19.6±4.3,P＜0.05),JOA score (12.3±1.6 vs.13.9±1.8,P＜0.05) and VAS score (6.3±2.6 vs.3.1±2.2,P＜0.05) changed significantly at the last follow-up compared with those pre-operation.There were no significant differences in the average ROM of implant segment (9.6°±4.2° vs.6.9°±5.3°,P＞0.05),the height ratio of implant segment and the superior vertebra (2.6±0.1 vs.2.5±0.1,P＞0.05) and the angle of functional spine unit (2.6°±5.2° vs.1.7°±2.9°,P＞0.05) at last follow-up compared with those preoperation.Conclusion Using DCI to treat cervical disc herniation had shorter operation time and less bleeding advantages,and the early clinical effect was satisfactory.It may retain the cervical biomechanical movement in some degree,maintain the cervical stability. Key words: Cervical vertebrae;  Intervertebral disk displacement;  Prostheses and implants;  Treatment outcome