中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (4): 701-704.doi: 10.3969/j.issn.1673-8225.2011.04.032

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

超级陶瓷合成物构建的脊椎间盘

辛  风，张  波，李继云   

  1. 北京大学深圳医院骨科，广东省深圳市   518036
  • 收稿日期:2010-08-09 修回日期:2010-12-16 出版日期:2011-01-22 发布日期:2011-01-22
  • 作者简介:辛风☆，男，1957年生，山东省日照县人，汉族，1982年哈尔滨医科大学毕业，博士，主任医师，主要从事脊柱疾病、关节疾病和骨质疏松症的研究。 Xf571012@ yahoo.com.cn

Advanced ceramics synthesized intervertebral discs

Xin Feng, Zhang Bo, Li Ji-yun   

  1. Department of Orthopedics, Peking University Shenzhen Hospital, Shenzhen  518036, Guangdong Province, China
  • Received:2010-08-09 Revised:2010-12-16 Online:2011-01-22 Published:2011-01-22
  • About author:Xin Feng☆, Doctor, Chief physician, Department of Orthopedics, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China Xf571012@yahoo. com.cn

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摘要：

背景：人工椎间盘置换在临床的应用已经取得了良好效果，但其假体的设计、磨损碎屑、骨质疏松症、翻修策略、病例选择等诸多因素均很大程度上影响手术的疗效。
目的：综述了人工椎间盘置换解决方案所面对的问题、未来一代人工椎间盘置换的需求、以及陶瓷技术公司的未来脊柱方案等问题。
方法：以 “Total Disc Replacement，vertebra，ceramics”为英文检索词，检索1990/2008 PubMed数据库和国际科学引文数据库文献。纳入与人工椎间盘置换术及陶瓷人工关节相关文献。排除重复性研究。重点对27篇文献进行了分析和讨论。
结果与结论：现在看起来人工椎间盘置换磨损要比髋关节和膝关节成形术的磨损要低。然而，人们所担忧的是磨损碎屑和任何继发的炎症反应可能发生在非常接近于神经结构的部位。有关人工椎间盘置换中全身金属离子释放的量还存有争议。MRI扫描会因存在有金属合金而出现人工伪影，至今还没有由制造商提供的有关进行MRI检查时植入物可能发热或移动的体外试验数据。复合材料Biolox® delta是超级的陶瓷材料，具有良好的生物相容性、耐磨性能和抵抗骨折特性，可以确保人工椎间盘置换在患者有生之年术后随访中表现出优越的放射学和MRI影像，可面对未来人工椎间盘置换解决方案需求的挑战。

关键词: 人工椎间盘置换, 脊椎, 陶瓷技术, 人工假体, 综述文献

Abstract:

BACKGROUND: Intervertebral disc replacement has obtained favorable effects in clinical application. However, prosthesis design, wearing debris, osteoporosis, revision strategy, and case selection can influence outcomes.
OBJECTIVE: To review problems in intervertebral disc replacement, requirements for future intervertebral disc replacement and future development trends of ceramics companies.
METHODS: With key words “total disc replacement, vertebra, ceramics” in English, PubMed and international science citation databases were searched for articles published between 1990 and 2008. Articles related to intervertebral disc replacement and ceramic joint were included. Repetitive studies were excluded. A total of 27 articles were discussed.
RESULTS AND CONCLUSION: Wearing degree of intervertebral disc replacement is lighter than hip and knee arthroplasty. However, people worry that wearing debris and any secondary inflammatory reaction occur adjacent to nerve structures. It remains controversial on metal ion release in intervertebral disc replacement. Metal alloy can induce artifacts in MRI scanning. To date, no in vitro experimental data are available on implant febrility or displacement in MRI examination. Composite material Biolox® delta is advanced ceramic material, with good biocompatibility, wearing and fracture resistance. It can ensure high quality of radiology and MRI images during follow-up of patients undergoing intervertebral disc replacement.

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