Coric Domagoj, Mummaneni Praveen V
Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina 28207, USA.
J Neurosurg Spine. 2008 Feb;8(2):115-20. doi: 10.3171/SPI/2008/8/2/115.
Nucleus replacement offers a less invasive alternative to traditional fusion or total disc replacement techniques in the treatment of symptomatic lumbar degenerative disc disease (DDD). The authors discuss the classification of nucleus replacement devices as well as their potential indications. The authors review the history and evolution of nucleus replacement devices emphasizing several that are actively in US Investigational Device Exemption pilot feasibility trials. Nucleus replacement devices can be functionally categorized as elastomeric and mechanical. A classification scheme is discussed. Nucleus replacement remains investigational, but early clinical results have been encouraging. Further clinical investigation with well-designed prospective, randomized pivotal trials is needed to determine the efficacy of nucleus replacement in the treatment of lumbar DDD, as well as its ideal indications.
在治疗有症状的腰椎退行性椎间盘疾病（DDD）时，髓核置换术为传统融合术或全椎间盘置换术提供了一种侵入性较小的替代方法。作者讨论了髓核置换装置的分类及其潜在适应证。作者回顾了髓核置换装置的历史和演变，重点介绍了几种正在美国进行研究性器械豁免试点可行性试验的装置。髓核置换装置在功能上可分为弹性体和机械性两类。文中讨论了一种分类方案。髓核置换术仍处于研究阶段，但早期临床结果令人鼓舞。需要通过精心设计的前瞻性、随机关键试验进行进一步的临床研究，以确定髓核置换术在治疗腰椎DDD中的疗效及其理想适应证。
