Kurtz Steven M, Toth Jeffrey M, Siskey Ryan, Ciccarelli Lauren, Macdonald Dan, Isaza Jorge, Lanman Todd, Punt Ilona, Steinbeck Marla, Goffin Jan, van Ooij André
Exponent, Inc.
Semin Spine Surg. 2012 Mar 1;24(1):57-70. doi: 10.1053/j.semss.2011.11.011.
Knowledge regarding the in vivo performance and periposthetic tissue response of cervical and lumbar total disc replacements (TDRs) continues to expand. This review addresses the following four main questions: 1) What are the latest lessons learned from polyethylene in large joints and how are they relevant to current TDRs? 2) What are the latest lessons learned regarding adverse local tissue reactions from metal-on-metal, CoCr bearings in large joints and how are they relevant to current TDRs? 3) What advancements have been made in understanding the in vivo performance of alternative biomaterials, such as stainless steel and polycarbonate urethane, for TDRs in the past five years? 4) How has retrieval analysis of all these various artificial disc bearing technologies advanced the state of the art in preclinical testing of TDRs? The study of explanted artificial discs and their associated tissues can help inform bearing selection as well as the design of future generations of disc arthroplasty. Analyzing retrieved artificial discs is also essential for validating preclinical test methods.
关于颈椎和腰椎全椎间盘置换术(TDR)的体内性能及假体周围组织反应的知识在不断扩展。本综述探讨以下四个主要问题:1)从大关节中的聚乙烯获得了哪些最新经验教训,以及它们与当前的TDR有何关联?2)从大关节中金属对金属、钴铬合金轴承的局部组织不良反应中获得了哪些最新经验教训,以及它们与当前的TDR有何关联?3)在过去五年中,在理解替代生物材料(如不锈钢和聚碳酸酯聚氨酯)用于TDR的体内性能方面取得了哪些进展?4)对所有这些不同的人工椎间盘轴承技术进行的取出分析如何推动了TDR临床前测试的技术水平?对取出的人工椎间盘及其相关组织的研究有助于指导轴承选择以及下一代椎间盘置换术的设计。分析取出的人工椎间盘对于验证临床前测试方法也至关重要。