摘要
背景:在术式微创化理念的发展下,腰椎后路动态内固定已成为治疗椎间盘退变疾病的主流术式。目的:综述腰椎后路动态内固定治疗腰椎退行性疾病及术后椎间盘再水化的最新进展。方法:检索CNKI、万方和PubMed数据库中2010-2025年发表的相关文献,中文检索词为“腰椎,动态内固定,椎间盘退变,Coflex系统,Dynesys系统,In-space系统,PercuDyn系统,椎间盘再水化,压应力”,英文检索词为“lumbar spine,dynamic internal fixation,intervertebral disc degeneration,Coflex system,Dynesys System,In-space System,PercuDyn System,intervertebral disc rehydration,crushing stress”。通过阅读文章剔除研究内容与文章主题关系不大、质量较差及内容陈旧的文献,最终纳入65篇文献进行归纳总结。结果与结论:①虽然如今治疗椎间盘退变疾病仍主要依赖于传统的开放手术方法进行置入操作,但是腰椎后路动态内固定已获得长足的发展;②腰椎后路动态内固定可以分为开放动态内固定系统和经皮动态内固定系统,每种系统内根据固定位置不同,又可以分为棘突间动态内固定系统和椎弓根动态内固定系统;根据具体器械的设计和术中操作方式的区别,衍生出不同的术式,目前国内外研究的热点集中于开放动态内固定系统;③腰椎后路动态内固定在临床效果优于传统椎间植骨融合术式的前提下,可使术后腰椎间盘出现再水化现象,进一步提高了患者术后的远期疗效。
BACKGROUND:With the development of the concept of minimally invasive surgery,lumbar posterior dynamic internal fixation has become the mainstream operation for the treatment of diseases caused by intervertebral disc degeneration.OBJECTIVE:To review the latest progress of lumbar posterior dynamic internal fixation in the treatment of lumbar degenerative diseases and postoperative intervertebral disc rehydration.METHODS:The relevant literature published in CNKI,WanFang,and PubMed databases from 2010 to 2025 was searched with the Chinese and English search terms“lumbar spine,dynamic internal fixation,intervertebral disc degeneration,Coflex system,Dynesys system,In-space system,PercuDyn system,intervertebral disc rehydration,crushing stress.”By reading the articles,we eliminated the literature with little relevance to the article topic,poor quality and outdated content,and finally 65 articles were included for summary.RESULTS AND CONCLUSION:(1)Although the main surgical method for the treatment of disc degeneration is still the traditional open surgical method of implantation,posterior lumbar dynamic internal fixation has made great progress.(2)Posterior lumbar dynamic fixation can be divided into open dynamic fixation system and percutaneous dynamic fixation system.Each system can be divided into interspinous dynamic internal fixation system and pedicle dynamic internal fixation system according to the different fixation positions.According to the design of specific instruments and the differences of operation methods in the surgery,different operation methods have been derived.At present,the focus of research at home and abroad is on open dynamic internal fixation system.(3)Under the premise that the clinical effect of posterior lumbar dynamic internal fixation is better than that of traditional interbody fusion surgery,it can cause the rehydration phenomenon of postoperative lumbar intervertebral disc,and further improve the long-term postoperative efficacy of patients.
作者
王鹏
李志军
张少杰
吴一民
Wang Peng;Li Zhijun;Zhang Shaojie;Wu Yimin(Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010000,Inner Mongolia Autonomous Region,China;School of Basic Medicine,Inner Mongolia Medical University,Hohhot 010000,Inner Mongolia Autonomous Region,China)
出处
《中国组织工程研究》
北大核心
2026年第3期711-720,共10页
Chinese Journal of Tissue Engineering Research
基金
内蒙古自治区首府地区公立医院高水平临床专科建设科技项目(2024SGGZ087),项目负责人:吴一民
内蒙古自治区科技计划项目(2021GG0395),项目负责人:吴一民。
