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[脊柱手术中的椎体置换]

[Vertebral body replacement in spine surgery].

作者信息

Kandziora F, Schnake K J, Klostermann C K, Haas N P

机构信息

Wirbelsäulenzentrum im Centrum für Muskuloskeletale Chirurgie, Klinik für Orthopädie, Klinik für Unfall- und Wiederherstellungschirurgie, Charité Universitätsmedizin Berlin.

出版信息

Unfallchirurg. 2004 May;107(5):354-71. doi: 10.1007/s00113-004-0777-z.

Abstract

Autografts and allogeneous bone grafts as well as cages are used for the reconstruction of the anterior column after corpectomy. Recently, expandable cages for vertebral body replacement have been developed. Based on our own experience, the purpose of this study was to summarize the available biomechanical and clinical data of expandable corpectomy cages and to compare it with established fixation techniques. If used correctly, expandable cages offer several surgical advantages in comparison to non-expandable cages. However there were no significant differences between the biomechanical properties of expandable and non-expandable cages. Additionally, design variations of expandable corpectomy cages did not show any significant impact on the biomechanical stability. Currently available mid-term clinical and radiological data on the treatment of fractures, metastasis and infection of the cervical, thoracic and lumbar spine demonstrated no significant difference between expandable and non-expandable cages. However, the increased stress-shielding effect of expandable cages compared to non-expandable cages might result in a deterioration of the long-term clinical outcome.

摘要

自体骨移植、异体骨移植以及椎间融合器被用于椎体切除术后前柱的重建。近来,已开发出用于椎体置换的可扩张椎间融合器。基于我们自身的经验,本研究的目的是总结可扩张椎体切除椎间融合器的现有生物力学和临床数据,并将其与既定的固定技术进行比较。如果使用得当,与不可扩张椎间融合器相比,可扩张椎间融合器具有若干手术优势。然而,可扩张和不可扩张椎间融合器的生物力学特性之间并无显著差异。此外,可扩张椎体切除椎间融合器的设计差异对生物力学稳定性并未显示出任何显著影响。目前关于颈椎、胸椎和腰椎骨折、转移瘤及感染治疗的中期临床和放射学数据表明,可扩张和不可扩张椎间融合器之间并无显著差异。然而,与不可扩张椎间融合器相比,可扩张椎间融合器的应力遮挡效应增加可能会导致长期临床疗效恶化。

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