人工椎体的发展与应用
摘要点击次数: 222   全文下载次数: 292   投稿时间:2016-10-23    
作者Author单位AddressE-Mail
刘俭涛 LIU Jian-tao 西安交通大学第二附属医院骨二科, 陕西 西安 710004 The Second Department of Orthopaedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China  
张峰 ZHANG Feng 西安市第四医院骨科, 陕西 西安 710000  
高正超 GAO Zheng-chao 西安交通大学第二附属医院骨二科, 陕西 西安 710004 The Second Department of Orthopaedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China  
牛斌斌 NIU Bin-bin 西安交通大学第二附属医院骨二科, 陕西 西安 710004 The Second Department of Orthopaedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China  
李宇欢 LI Yu-huan 西安交通大学第二附属医院骨二科, 陕西 西安 710004 The Second Department of Orthopaedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China  
贺西京 HE Xi-jing 西安交通大学第二附属医院骨二科, 陕西 西安 710004 The Second Department of Orthopaedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China xijing_h@vip.tom.com 
期刊信息:《中国骨伤》2017年,第30卷,第12期,第1157-1164页
DOI:10.3969/j.issn.1003-0034.2017.12.017
基金项目:高等学校博士学科点专项科研基金(编号:20120201130009)
中文摘要:人工椎体在治疗脊柱肿瘤、结核、骨折等疾病方面取得了较好的效果。目前人工椎体种类繁多、各有利弊,总体分为融合型与可动型2类,融合型根据高度能否调节及自稳性强弱分为支撑固定型、可调固定型、自固定型3三类,自固定型又因轴套螺纹旋转结构有高度能否调节之分;可动型因球窝关节或镂空结构等可动装置的存在代替了椎间盘的功能,一定程度上保留了脊柱的活动度。人工椎体的制作材料目前包括金属、陶瓷、生物材料及高分子复合材料等多种材料,金属以钛合金为主导,至今已发展至第3代,但仍存在表面生物活性不佳等缺陷;陶瓷以羟基磷灰石复合材料、磁性生物陶瓷、多晶氧化铝陶瓷等为代表,但是存在着加工复杂、力学性能参差不齐等缺陷;生物材料主要以异种骨为主,其结构与性能与人体骨最为接近,但是存在韧性低、制作复杂等缺陷;高分子复合材料因生物学特性总体分为生物降解型与非降解型,分别以聚乙交酯与聚乙烯为代表,各有利弊。假体的设计及制作材料虽取得了较大进步,但尚难以完全满足脊柱内置物的苛刻要求,有待进一步优化。3D打印技术使假体复杂结构的加工以及个体化定制成为可能,具有广阔的发展前景,但制作周期长、成本高等缺陷有待克服。虽然人工椎体在治疗脊柱疾病方面疗效显著,但不乏假体松动、移位的报道,加之评价标准不统一,随访时间短,其确切疗效有待进一步观察。
【关键词】生物假体  治疗应用  综述文献
 
Development and application of artificial vertebral body
ABSTRACT  Artificial vertebral body has achieved good results in treating spinal tumors,tuberculosis,fracture and other diseases. Currently,artificial vertebral body with variety of kinds and pros and cons,is generally divided into two types:fusion type and movable type. The former according to whether the height could be adjusted and strength of self-stability is divided into three types:support-fixed type,adjust-fixed type and self-fixed type. Whether the height of self-fixed type could be adjusted is dependent on structure of collar thread rotation. The latter is due to mobile device of ball-and-socket joints or hollow structures instead of the disc which retains the activity of the spine to some extent. Materials of artificial vertebral body include metals,ceramics,biomaterials,polymer composites and other materials. Titanium with a dominant role in the metal has developed to the third generation,but there are still defects such as poor surface bioactivity; ceramics with the representative of hydroxyapatite composite,magnetic bioceramics,polycrystalline alumina ceramics and so on,which have the defects of processing complex and uneven mechanical properties;biological material is mainly dominated by xenogeneic bone,which is closest to human bone in structure and properties,but has defects of low toughness and complex production;polymer composites according to biological characteristics in general consists of biodegradable type and non-biodegradable type which are respectively represented by poly-lactide and polyethylene,each with advantages and disadvantages. Although the design and materials of prosthesis have made great progress,it is difficult to fully meet requirements of spinal implants and they need be further optimized. 3D printing technology makes process of the complex structure of prosthesis and individual customization possible and has broad development prospects. However,long production cycles and high cost of defect should be overcome. Although artificial vertebral body has achieved curative effect in treating spinal disease,there were reports of implant loosening or displacement. Combining with evaluation standards not unified,short follow-up time,its exact effect needs further observation.
KEY WORDS  Bioprosthesis  Therapeutic uses  Review literature
 
引用本文,请按以下格式著录参考文献:
中文格式:刘俭涛,张峰,高正超,牛斌斌,李宇欢,贺西京.人工椎体的发展与应用[J].中国骨伤,2017,30(12):1157~1164
英文格式:LIU Jian-tao,ZHANG Feng,GAO Zheng-chao,NIU Bin-bin,LI Yu-huan,HE Xi-jing.Development and application of artificial vertebral body[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(12):1157~1164
查看  查看/发表评论  下载PDF阅读器
关闭

版权所有:《中国骨伤》杂志社京ICP备06016590号  版权声明
地址:北京市东直门内南小街甲16号,100700
电话:010-64089487 传真:010-64089792 Email:zggszz@sina.com