Kowalski R J, Ferrara L A, Benzel E C
Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Neurosurg Focus. 2001 Apr 15;10(4):E2. doi: 10.3171/foc.2001.10.4.3.
Bone fusion can be achieved by one or more of three methods: in situ, onlay, and interbody fusion. Interbody implants provide the spine with the ability to bear an axial load. They function optimally when placed along the neutral axis and produce little, if any, significant bending moment. Interbody implants may be comprised of bone, non-bone materials such as acrylic, or a combination of both such as in interbody cages. In this report the authors' goal is to provide some insight into the theoretical, as well as practical, biomechanical factors that influence bone fusion, focusing on interbody implants. They review the concept of stress shielding and its impact on fusion. With the attendant biomechanical nuances of the different regions of the spine, they discuss region-specific strategies involved in successful fusion. Finally, they review intraoperative techniques that will improve the chance of achieving a successful arthrodesis.
原位融合、覆盖植骨融合和椎间融合。椎间植入物使脊柱能够承受轴向负荷。当沿中性轴放置时，它们的功能最佳，并且几乎不会产生显著的弯矩（如果有，也很小）。椎间植入物可以由骨、非骨材料（如丙烯酸）或两者的组合（如椎间融合器）组成。在本报告中，作者的目标是深入探讨影响骨融合的理论和实际生物力学因素，重点关注椎间植入物。他们回顾了应力遮挡的概念及其对融合的影响。鉴于脊柱不同区域伴随的生物力学细微差别，他们讨论了成功融合所涉及的特定区域策略。最后，他们回顾了能够提高实现成功关节融合术几率的术中技术。
