人工腰椎间盘置换术治疗退变性腰椎间盘病的应用现状  

Application status of artificial lumbar disc replacement for lumbar degenerative disc disease

作　　者：杨风光 任恩惠 杨亮 王永刚[1,2,3] 汪静 康学文[1,2,3] YANG Fengguang;REN Enhui;YANG Liang;WANG Yonggang;WANG Jing;KANG Xuewen(Department of Orthopedics,Lanzhou University Second Hospital,Lanzhou 730000,China;Key Laboratory of Osteoarthritis of Gansu Province,Lanzhou 730000,China;International Scientific and Technological Cooperation Base of Gansu Province for the Research on Pain Mechanism of Spinal Disorders,Lanzhou 730000,China)

机构地区：[1]兰州大学第二医院骨科,甘肃兰州730000 [2]甘肃省骨与关节疾病重点实验室,甘肃兰州730000 [3]脊柱疾患疼痛机制研究及治疗甘肃省国际科技合作基地,甘肃兰州730000

出　　处：《中国医学物理学杂志》2019年第7期841-845,共5页Chinese Journal of Medical Physics

基　　金：国家自然科学基金(81371230);甘肃省青年科技基金(17JR5R230);兰州大学第二医院院内博士科研基金(ynbskyjj2015-1-01)

摘　　要：人工腰椎间盘置换术(ALDR)是利用人工假体替换病变椎间盘,恢复椎间隙高度的同时保持脊柱的稳定性和一定的活动范围,降低邻椎病的发生率,是治疗腰椎间盘退变性疾病(LDDD)的新方法,本研究就ALDR治疗LDDD的临床应用现状作一综述。Charité、ProDisc以及Activ-L是临床常用的人工椎间盘,但由于疗效不明显,Charité系列人工椎间盘已于2012年逐渐从市场撤出;目前临床常用的ProDisc系列人工腰椎间盘有ProDiscⅡ和ProDisc-L。ALDR可有效保留置换节段的活动度,降低邻椎病的发生率,对LDDD有较好的中短期疗效,但是假体下沉、移位、磨损、异位骨化及晚期置换节段融合等并发症的发生不容忽视。ALDR对LDDD的长期临床疗效以及潜在并发症仍需要长期的、大样本的随访研究。Artificial lumbar disc replacement (ALDR) is an innovative treatment of lumbar disc degeneration disease (LDDD) by replacing the intervertebral disc with artificial prosthesis,restoring the height of the intervertebral space while maintaining the stability of the spine and a certain range of motion,thereby reducing the incidence of adjacent segment disease.Herein the current clinical applications of artificial lumbar disc replacement in the treatment of LDDD are reviewed.Charité,ProDisc and Activ-L are commonly used artificial intervertebral discs in clinic.Due to the lack of obvious curative effect,the artificial intervertebral discs of Charité series have been gradually withdrawn from the market in 2012.For the artificial intervertebral discs of ProDisc series,ProDisc Ⅱ and ProDisc-L are commonly used in clinic.ALDR which can effectively retain the range of motion of the replacement segment and reduce the incidence of adjacent segment disease has good short- and medium-term therapeutic effects on LDDD.However,the complications such as the subsidence,displacement and wear of prosthesis,heterotopic ossification and late replacement segment fusion can't be ignored.Long-term clinical efficacy and potential complications of ALDR for LDDD still require long-term,large-sample follow-up studies.

关 键 词：腰椎间盘退变性疾病 人工腰椎间盘置换 生物力学特征 综述 

分 类 号：R318.1[医药卫生—生物医学工程] R681.57[医药卫生—基础医学]