中国组织工程研究

中国组织工程研究

• 骨与关节综述 bone and joint review • 上一篇    下一篇

颈椎前路融合与置换体外生物力学实验的新观点

吕聪伟1，2，3，蒲  婷2，3，廖振华3，刘伟强1，3   

  1. 1清华大学生物医学工程系, 北京市  100084；2清华大学深圳研究生院, 广东省深圳市  518055；3深圳清华大学研究院生物医用材料及植入器械重点实验室, 广东省深圳市  518057
  • 出版日期:2013-09-24 发布日期:2013-09-24
  • 通讯作者: 刘伟强，博士，教授，清华大学生物医学工程系，北京市 100084；深圳清华大学研究院生物医用材料及植入器械重点实验室，广东省深圳市 518057 weiqliu@hotmail.com
  • 作者简介:吕聪伟，男，1987年生，福建省漳州市人，汉族，2011年厦门大学毕业，主要从事植入式器械方面的研究。 86366359@qq.com
  • 基金资助:

    国家科技支撑计划“新型人工椎间盘”(2012BAI18B05)*； 深圳市重点实验室提升发展计划“生物型人工椎间盘关键技术研发”(CXB201005260044A)*

Advances in research on anterior cervical fusion and replacement in vitro biomechanical experiment

Lü Cong-wei 1, 2, 3, Pu Ting 2, 3, Liao Zhen-hua3, Liu Wei-qiang 1, 3   

  1. 1 Department of Biomedical Engineering, Tsinghua University, Beijing  100084, China; 2 Graduate School at Shenzhen, Tsinghua University, Shenzhen  518055, Guangdong Province, China; 3 Key Laboratory of Biomedical Materials and Implantable Devices, Research Institute of Tsinghua University in Shenzhen, Shenzhen  518057, Guangdong Province, China
  • Online:2013-09-24 Published:2013-09-24
  • Contact: Liu Weo-qiang, M.D., Professor, Department of Biomedical Engineering, Tsinghua University, Beijing 100084, China; Key Laboratory of Biomedical Materials and Implantable Devices, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, Guangdong Province, China weiqliu@hotmail.com
  • About author:Lü Cong-wei, Department of Biomedical Engineering, Tsinghua University, Beijing 100084, China; Graduate School at Shenzhen, Tsinghua University, Shenzhen 518055, Guangdong Province, China; Key Laboratory of Biomedical Materials and Implantable Devices, Research Institute of Tsinghua University in Shenzhen, Shenzhen 518057, Guangdong Province, China 86366359@qq.com
  • Supported by:

    National Science and Technology Support Planning Project, No. 2012BAI18B05*; Development Planning Project of Shenzhen Key Laboratory, No. CXB201005260044A*

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摘要：

背景：传统“金标准”颈前路减压植骨融合及近年来迅速发展的人工颈椎间盘置换是临床上常见的治疗颈椎病的方式。大量科研工作者和临床医生希望通过颈椎体外标本实验研究脊柱生物力学，为临床治疗提供指导数据。
目的：对现有颈椎体外标本生物力学实验研究进展进行综述，并对未来的研究方向进行展望。
方法：以“Cervical Spine, Fusion, Replacement, Hybrid, Biomechanics, In vitro, Adjacent-level Degeneration, Review”为英文检索词检索Pubmed数据库，以“颈椎，融合，置换，混合术，生物力学，体外，相邻节段退变，综述”为检索词检索CNKI数据库和万方数据库，检索2007年1月至2013年3月有关颈椎前路融合与置换体外生物力学实验研究进展的文献，主要整理近3年来相关研究，排除陈旧文章和重复性工作，最后对40篇文献进行归纳与讨论。
结果与结论：文章对现有的颈椎体外标本融合、置换实验进行总结，集中体现在手术多节段、运动控制条件差异化、颈椎耦合运动测试和新型植入器械4个方面，对比总结融合与置换治疗对邻近节段运动范围、关节内压力、髓核内压力和椎间孔形态的影响，探讨融合、置换后存在的问题。最后结合临床的需求，展望颈椎体外标本实验的发展趋势及应用前景。

关键词: 骨关节植入物, 骨与关节综述, 颈椎, 融合, 置换, 混合治疗, 生物力学, 体外, 相邻节段退变, 部级基金

Abstract:

BACKGROUND: Traditional “gold standard” of anterior cervical decompression with fusion and artificial cervical disc replacement rapidly developed in recent years are common clinical methods for the treatment of cervical spondylosis. A large number of researchers and clinicians hope to research the biomechanics of spine through cervical specimen in vitro experiments, which provide guidance for clinical surgery.
OBJECTIVE: To review the cervical specimen in vitro experiments and to prospect the future research.
METHODS: The PubMed database, CNKI database and Wanfang database were retrieved with the key words of “cervical spine, fusion, replacement, hybrid, biomechanics, in vitro, adjacent-level degeneration, review” in English and Chinese. The articles in the past 3 years on the in vitro biomechanical experiments of anterior cervical fusion and replacement from January 2007 to March 2013 were included. The old and repetitive articles were excluded. Finally, a total of 40 articles were included for review.
RESULTS AND CONCLUSION: This article reviewed the in vitro cervical specimen fusion and replacement experiments, and introduced major progress in multi-level, motion control condition differences, cervical coupled motion test and newly designed implant device. The effects of fusion and replacement on adjacent-level range of motion, intra-articular pressure, pressure inside nucleus pulposus and intervertebral foramen morphology were compared to discuss the problems after fusion and replacement, and thus prospecting the development and application of in vitro cervical specimen experiments based on the clinical requirements.

Key words: cervical vertebrae, spinal fusion, arthroplasty, replacement, biomechanics, review

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