Prosthesis structure and application features of artificial cervical disc

doi:10.3969/j.issn.2095-4344.2014.26.029

Abstract

Abstract:

BACKGROUND: The design and use of artificial cervical disc prosthesis have great development, such as rubber-made artificial cervical disc with low-friction sliding surface and spring system, and other various elastic prostheses.
OBJECTIVE: To summarize structural characteristics and present application of artificial cervical disc prosthesis.
METHODS: The first author searched CNKI (2000-2013) and PubMed databases (1960-2013) http://www.ncbi.nlm.nih.gov/PubMed for literatures on application of artificial cervical disc prosthesis. The key words included artificial cervical disc, prosthesis, intervertebral disc herniation, the surgical therapy. 200 literatures and 56 literatures were respectively searched in CNKI and the PubMed. Titles and abstracts were read. A total of 40 literatures were in accordance with inclusion criteria and included.
RESULTS AND CONCLUSION: Artificial cervical disc prosthesis was consistent with physiological functions of intervertebral disk. The material is characterized by abrasion, fatigue resistance and corrosion resistance, is similar to physiological and biomechanical function of human disc, maintains the stability of the spine and motor function, and avoids the accelerated degeneration of adjacent segments. Articles mainly introduced the structure of Bryan, Mobi-C, PCM, Prodisc-C, Prestige and CerviCore artificial cervical disc. Short-period therapeutic effects of artificial cervical disc replacement have obtained approval. However, it cannot completely replace anterior cervical fusion, but is another manner to treat cervical degenerative disc disease.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: cervical spondylosis, intervertebral disk, prostheses and implants

CLC Number:

R318

Yan Duan-guo. Prosthesis structure and application features of artificial cervical disc[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(26): 4260-4264.

Figures/Tables 6

2.1 人工颈椎间盘假体生理学和生物力学标准人工颈椎间盘假体要求材料组织相容性好，耐腐蚀、耐磨损和抗疲劳；应能承受多年的生物力学负荷，它植入后应具备正常脊柱的曲线弧度和重建颈椎的前凸角度，不可对后方小关节形成过重的生物力学负荷；可以重建椎间隙的高度和稳定性，缓冲震荡力量，恢复脊柱的生理运动功能，可以使脊柱在矢状面、冠状面及水平方向保持生物力学运动，可以抵抗超负荷运动及可以对抗轴向压缩的力量，但是至今为止，尚没有一种人工颈椎间盘假体完全符合全部标准[4-7]。 2.2 人工颈椎间盘假体 Bryan人工颈椎间盘属于非限制型人工颈椎间盘，是当前使用最广泛的人工颈椎间盘，Vincent Bryan 在20世纪90年代设计了Bryan人工颈椎间盘，它呈一体化设计，假体设计有14，15，16，17，18 mm 5种规格，高度全部为815 mm。整个假体由上下两片钛合金外壳和中间的聚亚氨酯髓核组成，钛合金外壳表面为多孔涂层设计，利于骨长入，提供固定的稳定性(图1)[8]。聚亚氨酯髓核有2 mm的平移范围和11°的活动度设计。聚亚氨酯壳包绕着髓核附着在合金壳内形成一个密室，限制可能产生的碎屑外漏。密室内的生理盐水被钛合金封闭于内，起到降低摩擦的作用，前方的突起可以限制假体的后移同时提供植入时的把持固定作用[9-10]。国外Kim等[11]对颈椎前路融合内固定和Bryan人工颈椎间盘假体置换进行了大样本量的对照试验统计学研究，463例需要手术的颈椎病患者随机分组，手术后随访2年。结果显示：颈椎功能障碍指数评分、重返工作时间、颈臂痛视觉模拟量表评分和健康调查简表评分Bryan人工颈椎间盘组都优于颈椎前路融合内固定组；Bryan人工颈椎间盘组术后并发症低于对比组。Ren等[12]对Bryan人工颈椎间盘置换患者治疗后随访，JOA评分，颈椎功能障碍指数，neck disability index 评分优于对照组而且颈椎活动度满意。国内贺宝荣等[13]对照研究Bryan人工颈椎间盘置换后疗效和置换前后颈椎活动度大小。结果显示疗效和颈椎活动度满意。"

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