人工颈椎间盘临床应用现状和发展前景  

Clinical application status and development prospect of artificial cervical intervertebral disc

作　　者：邓德钧(综述) 李贤坤(审校)[1] DENG De-jun;LI Xian-kun(Spinal surgery,Huizhou Third People's Hospital,Huizhou 516002,Guangdong,CHINA)

机构地区：[1]惠州市第三人民医院脊柱外科,广东惠州516002

出　　处：《海南医学》2021年第17期2254-2257,共4页Hainan Medical Journal

摘　　要：传统颈椎手术会导致颈椎活动度下降和"邻椎病"等情况,人工椎间盘置换术是解决这些并发症的重要手段。从Fernstrom创造第一代人工椎间盘,到改良后的Bristol-Cummins/Frenchay/Prestige人工颈椎间盘,再到使用较多的Bryan金属-聚乙烯人工颈椎间盘,都存在诸多问题。人工颈椎间盘的旋转中心选择、表面材料性质、关节面数量、运动限制的类型、固定方式、材料性质都影响人工颈椎间盘的中、长期稳定性。人工颈椎间盘理论上保留了椎体的活动度,最大限度模拟了颈椎的活动度,减少"邻椎病"发生。至今为止其表现出来的缺点包括不合适尺寸的假体会导致假体松动、脱位以及金属板损坏;手术难度大,导致减压不彻底,手术效果欠佳;脊髓或神经根损伤;血肿和感染等。人工颈椎间盘置换术作为一种高难度的手术,无论是手术本身还是器械都存在较多的问题,现今研究的热点主要集中在新结构设计、面向种群设计和材料改进方面。Traditional cervical spine surgery can lead to the decline of cervical mobility and"adjacent segment disease".Artificial disc replacement is an important means to solve these complications.From the first-generation artificial cervical disc created by Fernstrom,to the improved Bristol-Cummins/French/prestige artificial cervical disc,to the more used Bryan metal-polyethylene artificial cervical disc,there are still many problems.The selection of rotation center,the properties of surface materials,the number of articular surfaces,the types of motion limitation,the fixation methods,and the properties of materials all affect the medium and long-term stability of the artificial cervical disc.Theoretically,the artificial cervical disc retains the mobility of the vertebral body,simulates the mobility of the cervical spine to the maximum extent,and reduces the occurrence of"adjacent segment disease".So far,its disadvantages include prosthesis loosening,dislocation,and metal plate damage caused by improperly sized prosthesis;incomplete decompression,poor surgical effects caused by difficult operation;spinal cord or nerve root injury;hematoma and infection.Artificial cervical disc replacement,as a highly difficult operation,has many problems in both the operation itself and the instruments.Current research hotspots mainly focus on new structure design,population-oriented design and material improvement.

关 键 词：人工颈椎间盘 研究前沿 优缺点 设计理念 新型材料 颈椎病 

分 类 号：R681.53[医药卫生—骨科学]