外科学
样例:人工髓核置换术治疗退变性腰椎间盘疾病初步报告
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- 摘要:目的 评价人工髓核置换术治疗退变性腰椎间盘疾病的近期效果。方法 行人工髓核置换术21例，均采用单枚PDN置入，PR 725型4例，PR 925型1例，PW 525型2例，PW 725型14例。结果所有患者均获得随访，平均105个月。患者术后临床症状、运动功能明显改善，椎间隙高度增加。早期有2例假体发生移位，但无明显症状。结论 PDN置换术能有效恢复退变性椎间盘疾病患者的椎间盘高度，近期效果肯定。
3讨论
由于椎间盘最早发生退变的结构是髓核，单纯髓核置换恢复了纤维环的张力和节段稳定性而未影响椎体终板的完整性，可能更能成功地重建椎间盘的功能［1］。单纯髓核置换的手术操作较全椎间盘置换简单，且创伤小、失败及潜在危险性较小、所需手术时间较短，因此，更易被医生和患者接受；另一大优点是有可能用微创外科技术、甚至在内窥镜下置入［1］。由于人工髓核假体需正常纤维环约束和通过再膨胀纤维环来减轻髓核的负荷，故仅适用于早、中期椎间盘退行性病变，而不适用于严重椎间盘退行性病变和椎间隙变窄者［2～4］，这也是其主要局限性。人工髓核有许多种设计，其中美国Raymedica 公司生产的PDN（prosthetic disc nucleus）是目前临床应用最多、技术最成熟的一种［1］。
有少量瑕疵译文
Abstract: Objective To evaluate the short-term effect of prosthetic disc nucleus replacement on degenerative lumbar disc disease. Methods 21 cases had the prosthetic disc nucleus replacement through single-PDN placement, including 4 cases of PR 725 type, 1 case of PR 925 type, 2 cases of PW 525 type and 14 cases of PW 725 type. Results All patients were followed up, with an average of 10 5 months. The postoperative clinical symptoms and motor functions were both improved significantly; the height of intervertebral space increased. There were two early shifts of grafts, but no obvious symptoms were found. Conclusion PDN replacement can effectively increase the height of intervertebral space in patients with degenerative lumbar disc disease; the short-term effect is obvious.
3 Discussion
As the disc degeneration first occurs in the nucleus, simple disc nucleus replacement restores the tension of fibrous ring and the stability of the segment without affecting the integrity of vertebral end plate: it may reconstruct the disc functions more successfully [1]. The simple disc nucleus replacement can be operated more simply than the total disc replacement, with less wound, small failure and potential danger, and short time for surgery. As a result, it is accepted by doctors and patients more easily. Another advantage is that it might be achieved with minimally invasive surgery, even with the placement under endoscope [1]. As the artificial nucleus graft should be bound by normal fibrous ring and alleviate the load on the nucleus through further expansion of fibrous ring, it is only suitable for early and mid disc degeneration, but not for severe disc degeneration and narrow of intervertebral space [2~4], which is the main limitation. There are many types of artificial nucleus, in which the PDN (prosthetic disc nucleus) produced by the Raymedica Company in United States is most widely used, with the most mature technology [1].
修改后译文
Abstract: Objective To evaluate the short-term effect of prosthetic disc nucleus replacement on degenerative lumbar disc disease. Methods 21 cases had the prosthetic disc nucleus replacement through single-PDN placement, including 4 cases of PR 725 type, 1 case of PR 925 type, 2 cases of PW 525 type and 14 cases of PW 725 type. Results All patients were followed up, with an average of 10 5 months. The postoperative clinical symptoms and motor functions were both improved significantly and the height of intervertebral space increased. In the early stage, the grafts of two cases shifted, but no obvious symptoms were found. Conclusion PDN replacement can effectively increase the height of intervertebral space in patients with degenerative lumbar disc disease and the short-term effect is obvious.
3 Discussion
As the disc degeneration first occurs in the nucleus, simple disc nucleus replacement restores the tension of fibrous ring and the stability of the segment without affecting the integrity of vertebral end plate. It may reconstruct the disc functions more successfully [1]. The simple disc nucleus replacement can be operated more simply than the total disc replacement, with less wound, less failure, small potential danger and short time for surgery. As a result, it is accepted by doctors and patients more easily. Another advantage is that it might be achieved with minimally invasive surgery, even with the placement under endoscope [1]. As the artificial nucleus graft should be bound by normal fibrous ring and alleviate the load on the nucleus through further expansion of fibrous ring, it is only suitable for early and mid disc degeneration, and not for severe disc degeneration and narrowed intervertebral space [2~4], which is the main limitation. There are many types of artificial nucleus, in which the PDN (prosthetic disc nucleus) produced by the Raymedica Company in the United States is most widely used clinically with the most mature technology [1]
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