人工腰椎间盘假体设计原理及现状  

Current situation and principle for design of artificial lumbar disc prostheses

作　　者：吴刚[1] 孙常太[1] 黄公怡[1] 

机构地区：[1]卫生部北京医院骨科,北京市100730

出　　处：《中国组织工程研究与临床康复》2007年第1期156-159,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:人工腰椎间盘置换术作为腰椎融合之外治疗腰椎间盘退行性病变的另一合理的选择,使患者疼痛缓解,重建椎间隙高度,保留脊柱运动,在欧美已经应用于临床。结合腰椎解剖及生物力学原理阐述目前常用假体的设计理念。同时,综述目前FDA批准的SBCharité假体早期临床研究结果。资料来源:应用计算机检索MEDLINE和PUBMED公开的截止到2006-10文献,检索词“Discarthroplasty;Lumbarspine;Discdegeneration;Spineprosthesis;Artificialdisc;Intervertebraldisc”,限定文章语言种类为English。通信获得北美脊柱学会及脊柱侧凸学会从1995到2005年历年的会议部分文献。资料选择:对资料进行初审。纳入标准:①实验及临床研究。②不限定对照及盲法。排除标准:同一领域重复研究和综述文献。资料提炼:从95篇关于人工腰椎间盘置换假体基础研究及临床应用的文献中选出符合纳入标准的30篇。资料综合:文献报道分别对腰椎解剖及生物力学原理、人工腰椎间盘假体设计理念、目前常用假体的特点及应用指征、短期临床效果及随访情况等进行讨论。①腰椎运动的生物力学机制要求设计出一种能够重建和保留脊柱生理活动功能的假体与之相适应。②FDA关于CharitéⅢ假体的2年RCT临床随访资料显示63%的患者临床效果满意。10年随访资料显示Charité人工椎间盘具有极好的屈伸及侧方动度而没有显著的并发症,优于文献中脊柱融合的疗效。结论:短期的疼痛缓解和功能恢复效果良好;植入体内短期内是相对安全的;相对于脊柱融合术,可缩短术后康复时间。术后短期效果可以肯定,但缺乏有关远期效果的报告。OBJECTIVE： Despite lumbar spine fusion, artificial disc replacement is a more recent option for lumbar degenerative disc disease that preserves spinel motion, recreates the natural height of the space and pain relief. It has been applied in clinical treatment in Europe and America. To explain the design principle of artificial disc prosthesis based on the lumbar spine anatomy and biomechanics theory, meanwhile, to review the early clinical results of SB Charite prosthesis approved by FDA. DATA SOURCES： A computer-based search was conducted in MEDLINE and PUBMED. for articles related to lumbar artificial disc replacement published before October2006 with the key words of ＂Disc arthroplasty; Lumbar spine; Disc degeneration; Spine prosthesis; Artificial disc; Intervertebral disc＂, and the language was limited to English. In addition, part of the abstracts from the annual meetings of the North American Spine Society and Sceliosis Research Society from 1995 to 2005 ware gained by correspondence. STUDY SELECTION All articles ware selected firstly based on the inclusion criteria： ①Experimental studies and clinical researches. ② No limits for control and blind method. Exclusion criteria： repeated studies and reviews in the same field. DATA EXTRACTION： Thirty articles accordant with the inclusion criteria were collected from ninety-five researches about the fundamental study and clinical application of lumbar artificial disc replacement prosthesis. DATA SYNTHESIS ： The reviews ware performed on the lumbar anatomy and biomechanical theory, design principle of artificlal disc prosthesis, features and application indications of commonly used prosthesis, short-term clinical result and follow-up. ① The biomechanical theory demanded a certain prosthesis, which was able to reconstruct and maintain the physiological functions of lumbar spine. ②24-month follow-up data available in FDA for the Charite Ⅲ prosthesis indicated that 63% of subjects in the Charite group subjects satisfied with the clinical eff

关 键 词：腰椎 椎间盘 假体设计 解剖学 生物力学 

分 类 号：R496.1[医药卫生—康复医学]