植骨材料在脊柱结核治疗中的应用与特征  

Application and characteristics of bone graft materials in the treatment of spinal tuberculosis

作　　者：李辉[1] 陈良龙[1] Li Hui;Chen Lianglong(Loudi Central Hospital,Loudi 417100,Hunan Province,China)

机构地区：[1]娄底市中心医院,湖南省娄底市417100

出　　处：《中国组织工程研究》2022年第4期626-630,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:在脊柱结核的外科手术治疗中,彻底清除局部坏死病灶、一期使用骨修复材料能显著促进局部骨性融合,避免术后中远期结核复发,重建脊柱稳定性。目的:对植骨材料在治疗脊柱结核中的应用进展做一综述。方法:检索2001-2020年百链数据库、中国知网、Natures数据库等收录的与植骨材料治疗脊柱结核相关的文章,优先选择年限较新和权威杂志上的文献。英文检索词为"Bone graft materials;bone tissue engineering;spinal tuberculosis;titanium mesh;autogenous bone",中文检索词为"植骨材料;骨组织工程;脊柱结核;钛网;自体骨"。结果与结论:目前植骨材料已被广泛应用于临床,各有其劣势,如:自体骨骨量有限,且自体骨的移植会引起供区出血和供骨区潜在的并发症;同种异体骨会导致延迟愈合和感染等并发症;钛网存在术后沉降及后凸畸形矫正角度再丢失的问题;以聚乳酸、聚甲基丙烯酸甲酯等为代表的有机高分子材料包埋药物体系缺乏骨诱导性能;钙磷基陶瓷材料虽可作为抗结核药物的载体材料,但其生物力学性能常不能完全满足临床需要。鉴于以上各种材料的缺点,临床上需要寻找一种同时满足良好生物相容性、机械性能、降解性能、成骨活性、载药缓释性能的复合骨组织工程材料。BACKGROUND: Thorough removal of local necrotic lesions and one-stage use of bone repair materials can significantly promote local bony fusion, avoid recurrence of tuberculosis in the middle and long terms and reconstruct spinal stability in the surgical treatment of spinal tuberculosis. OBJECTIVE: To review the application of bone graft materials in the treatment of spinal tuberculosis.METHODS: The first author searched the articles related to bone graft materials of spinal tuberculosis in Bailian, CNKI, and Natures databases published from 2001 to 2020. The priority was the articles published recently or in authoritative journals. The search keywords were "bone graft materials, bone tissue engineering;spinal tuberculosis;titanium mesh;autogenous bone" in Chinese and English.RESULTS AND CONCLUSION: At present, bone graft materials have been widely used in clinic, but each has its own disadvantages. For example, the amount of autologous bone is limited, and the transplantation of autologous bone will cause bleeding and potential complications of donor site;allogeneic bone will lead to delayed healing and infection;titanium mesh has the problems of postoperative subsidence and kyphosis correction angle loss;the organic polymer materials such as polylactic acid and polymethyl methacrylate are lack of bone induction performance. Although Ca/P-based ceramic materials can be used as carrier materials of antituberculosis drugs, their biomechanical properties cannot fully meet the clinical needs. In view of the shortcomings of the above materials, it is necessary to find a composite bone tissue engineering material, which can meet the requirements of good biocompatibility, mechanical properties, degradation properties, osteogenic activity, and drug release performance.

关 键 词：骨 材料 骨组织工程 脊柱结核 钛网 同种异体骨 骨修复 钙磷陶瓷 植骨材料 综述 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学]