Zdeblick Thomas A, Phillips Frank M
Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison, Wisconsin, USA.
Spine (Phila Pa 1976). 2003 Aug 1;28(15 Suppl):S2-7. doi: 10.1097/01.BRS.0000076841.93570.78.
A literature review was conducted of basic science research and clinical experiences describing the use of interbody cage devices for the management of degenerative spinal abnormalities.
To summarize current knowledge regarding the use of interbody fusion cages.
Degenerative conditions of the lumbar and cervical spine are a major societal expense and a leading cause of disability. Fusion surgery may be used to treat patients with some of these conditions. During the past decade, interbody cages have been popularized as a useful fusion technique with high rates of clinical and radiographic success reported. Cages may be implanted using a variety of surgical approaches to the disc space and can be used alone or with supplemental posterior fixation.
A literature review of biomechanical, biologic, and clinical studies of threaded interbody cages was performed.
Interbody cages have been shown to successfully promote fusion in a variety of animal models. In biomechanical studies, anteriorly placed threaded cages significantly stabilize the motion segment in all directions except extension. Posteriorly placed cages provide less stability as a result of the facetectomy required for placement of an appropriately sized device. Successful clinical and radiographic results have been reported with the use of interbody cages. Most reported cage failures are the result of technical difficulties with implantation or poor patient selection. Accurate radiographic assessment of fusion in the presence of a metal interbody cage remains challenging, and studies evaluating alternate biomaterial cages are underway.
Interbody cages are a useful technique for achieving spinal fusion and have been shown to have an acceptable clinical success rate in appropriately selected patients.
对描述椎间融合器用于治疗退行性脊柱异常的基础科学研究和临床经验进行了文献综述。
总结有关椎间融合器使用的当前知识。
腰椎和颈椎的退行性疾病是一项重大的社会支出，也是导致残疾的主要原因。融合手术可用于治疗其中一些疾病的患者。在过去十年中，椎间融合器已作为一种有用的融合技术得到推广，据报道临床和影像学成功率很高。可采用多种手术入路将融合器植入椎间盘间隙，且可单独使用或与后路辅助固定联合使用。
对带螺纹椎间融合器的生物力学、生物学和临床研究进行了文献综述。
在多种动物模型中，椎间融合器已被证明能成功促进融合。在生物力学研究中，前路放置的带螺纹融合器在除伸展外的所有方向上均能显著稳定运动节段。由于放置合适尺寸的装置需要进行小关节切除术，后路放置的融合器提供的稳定性较差。使用椎间融合器已报告了成功的临床和影像学结果。大多数报告的融合器失败是植入技术困难或患者选择不当的结果。在存在金属椎间融合器的情况下，对融合进行准确的影像学评估仍然具有挑战性，目前正在进行评估替代生物材料融合器的研究。
椎间融合器是实现脊柱融合的一种有用技术，在适当选择的患者中已显示出可接受的临床成功率。
