中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (17): 3201-3204.doi: 10.3969/j.issn.1673-8225.2012.17.036

• 骨与关节学术探讨 academic discussion of the bone and joint • 上一篇    下一篇

腰椎棘突间非融合植入物的特点及生物力学特性★

许  刚1，陈广栋2，陈建常3，张  洋3，刘  聪3   

  1. 解放军兰州军区乌鲁木齐总医院，1骨三科，3骨二科，新疆维吾尔自治区乌鲁木齐市830000；2新疆医科大学研究生学院，新疆维吾尔自治区乌鲁木齐市830011
  • 收稿日期:2012-02-03 修回日期:2012-02-14 出版日期:2012-04-22 发布日期:2012-04-22
  • 通讯作者: 陈广栋，硕士，新疆医科大学研究生学院，新疆维吾尔自治区乌鲁木齐市 830011 victordongdong@sina.com
  • 作者简介:许刚★，男，1970年生，宁夏回族自治区银川市人，硕士，副主任医师，主要从事关节外科研究。

Characteristics and biomechanical properties of lumbar interspinous non-fusion implant

Xu Gang1, Chen Guang-dong2, Chen Jian-chang3, Zhang Yang3, Liu Cong3   

  1. 1Third Department of Orthopedics, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA, Urumqi  830000, Xinjiang Uygur Autonomous Region, China; 2Graduate College, Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China; 3Second Department of Orthopedics, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA, Urumqi  830000, Xinjiang Uygur Autonomous Region, China
  • Received:2012-02-03 Revised:2012-02-14 Online:2012-04-22 Published:2012-04-22
  • Contact: Chen Guang-dong, Master, Graduate College, Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China victordongdong@sina.com
  • About author:Xu Gang★, Master, Associate chief physician, Third Department of Orthopedics, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA, Urumqi 830000, Xinjiang Uygur Autonomous Region, China

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摘要：

背景：非融合技术可以避免椎间盘髓核摘除和脊柱融合固定治疗椎退行性病变导致的椎间盘丧失原有的生物力学功能或加剧蜕变。
目的：总结各种腰椎棘突间非融合植入物特点、疗效及置入后生物力学的变化。
方法：作者检索1990/2012 PubMed数据库及中国知网数据库检索与腰椎棘突间非融合植入物治疗脊柱退行性病变的相关研究。
结果与结论：共纳入31条文献。棘突间非融合植入物能撑开病变节段棘突间隙，防止过度后伸，从而增加相应水平椎管横截面积和椎间孔高度，降低椎间盘负荷和小关节负荷，控制异常活动，保持运动功能来预防邻近节段退变，使失稳的腰椎达到正常状态的活动特性，实现动态重建腰椎序列。腰椎棘突间植入物可根据其特性及作用特点分为静态和动态两类，分别以X-STOP和Coflex为代表。由于不同的腰椎棘突间非融合植入物具有不同的特点，因而适应症状有所不同，应通过鉴别患者的不同发病原因，选择最合适的棘突间非融合器械进行个体化治疗，使其植入后更加符合生理情况应力分布。
关键词：腰椎棘突间非融合植入物；腰椎退行性病变；生物力学；医学植入物；组织工程
doi:10.3969/j.issn.1673-8225.2012.17.036

关键词: 腰椎棘突间非融合植入物, 腰椎退行性病变, 生物力学, 医学植入物, 组织工程

Abstract:

BACKGROUND: Non-fusion technology can avoid the loss of original biomechanical function or aggravation of intervertebral disc as a result of intervertebral discectomy and spinal fusion fixation for the treatment of lumbar vertebral degenerative lesions.
OBJECTIVE: To summarize the characteristics and treatment efficacy of various lumbar interspinous fusion implants, as well as their biomechanical changes after implantation.
METHODS: An online retrieval was performed among PubMed database and Chinese CNKI database between 1990 and 2012 for articles about lumbar interspinous fusion implants in the treatment of spinal degenerative disease.
RESULTS AND CONCLUSION: A total of 31 documents were screened out. Interspinous non-fusion implants can open spinous process gap at lesioned segments, prevent excessive extension, accordingly increase the spinal canal cross-sectional area and foraminal height, reduce the loads of intervertebral disc and facet joint, regulate abnormal activity, preserve motor function to prevent the degeneration of adjacent segment, maintain normal state activity of the instable lumbar vertebra, and realize the dynamic reconstruction of lumbar sequence. According to its characteristics, lumbar interspinous implants are divided into two kinds, namely static and dynamic, which are representative of X-STOP and Coflex, respectively. Due to different lumbar interspinous non-fusion implants possess various characteristics and indications, it is suggested that physicians should clearly identify the disease causes, choose the most appropriate interspinous non-fusion device for individual treatment, and make the implants more consistent with physiological stress distribution.

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