摘要
背景:对于保守治疗无效的颈椎病患者,颈椎前路减压融合一直作为其手术治疗的金标准。自其使用以来,其术中操作简单便捷,术后病变节段症状显著缓解,得到临床医生的广泛认可。随着时间的延长,相邻节段退变及置换节段的活动度丧失等问题逐渐暴露出来。与此同时,随着患者对术后康复水平和生活质量要求的不断提高以及手术技术的不断发展,该术式已不能满足临床需要,此时一种既能解决颈椎前路减压融合带来的相关问题,临床效果又优于该术式的颈椎全椎间盘置换应运而生。目的:综述人工颈椎间盘的研究现状,重点阐述人工椎间盘的临床效果及结构,并展望其改进及发展方向。方法:通过计算机在中国知网、万方数据库、PubMed数据库中检索相关文献,检索时限为1995年1月至2019年8月。检索的中文主题词为“非融合技术,人工椎间盘,临床疗效,结构”;英文主题词为“non-fusion technique,artificial intervertebral disc,clinical efficacy,structure”,筛选研究内容与人工颈椎间盘相关的文献,着重选取最新的实验及临床研究成果。结果与结论:①通过对目前市场上主要的人工颈椎间盘进行分析,发现未来人工颈椎间盘的研究将会着重于假体材料、假体结构、假体置入器械及手术入路等方面,同时未来国内的人工颈椎间盘还将基于国人颈椎解剖学特征进行设计;②相信未来的颈椎间盘置换在取得较好的临床效果的同时,其术后并发症将会显著减少,更能满足国人的需要。
BACKGROUND:For patients with cervical spondylosis who fail to receive conservative treatment,cervical anterior decompression and fusion has always been the gold standard for surgical treatment.Since its use,it has been widely recognized by clinicians for its simple and convenient intraoperative operation and significant relief of pathological segmental symptoms after surgery.As time goes by,the problem of degeneration of surgery adjacent segments and loss of mobility of the replacement segments is gradually exposed.At the same time,the patient’s requirements for postoperative rehabilitation and quality of life are constantly improving,and surgical technology continues to develop rapidly.This type of surgery cannot meet the clinical needs.Therefore,total cervical disc replacement surgery comes into being,which can solve the related problems caused by anterior cervical decompression and fusion,and the clinical effect is better than previous one.OBJECTIVE:To review the research status of artificial cervical intervertebral discs,to focus on its clinical effects and structure,and to prospect its improvement and development direction of artificial development direction.METHODS:A compute-based retrieval of CNKI,WanFang and PubMed databases was conducted for articles published between January 1995 and August 2019.The keywords were“non-fusion technique,artificial intervertebral disc,clinical efficacy,structure”in Chinese and English,respectively.The articles related to artificial cervical intervertebral disc were selected,and the latest experimental and clinical researches were preferred.RESULTS AND CONCLUSION:(1)Through analyzing the main artificial cervical discs on the market,the research of artificial cervical discs will focus on materials,structures,implantation devices and surgical approaches of prosthesis.The domestic cervical disc will be designed based on the anatomical features of the Chinese cervical spine.(2)It is believed that the future cervical disc replacement surgery will achieve a satisfactory clinical effect,and its postoperative complications will be significantly reduced,which can meet the requirements of Chinese people.
作者
李游
郑蹦蹦
王佳明
马勇胜
Li You;Zheng Bengbeng;Wang Jiaming;Ma Yongsheng(Department of Orthopedics,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,Heilongjiang Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第12期1941-1948,共8页
Chinese Journal of Tissue Engineering Research
关键词
非融合技术
人工椎间盘
临床疗效
结构
材料
解剖学
non-fusion technique
artificial intervertebral disc
clinical efficacy
structure
material
anatomy
