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一种将人工椎间盘髓核与柔性稳定装置相结合的前路脊柱内固定器械:制造及在椎间盘修复中的应用。

Anterior spinal instrumentation combining a prosthetic disc nucleus with a flexible stabilization device: Manufacture and use in intervertebral disc repair.

作者信息

Bao Da, Li Dawei

机构信息

Department of Orthopedics, The 309th Hospital of PLA, Beijing 100091, P.R. China.

出版信息

Exp Ther Med. 2018 Mar;15(3):3040-3044. doi: 10.3892/etm.2018.5745. Epub 2018 Jan 12.

DOI:10.3892/etm.2018.5745
PMID:29456709
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5795529/
Abstract

Artificial disc replacement alone is unable to completely cure cervical degenerative diseases; thus, a stabilization device markedly improves patient recovery. In order to meet this requirement, an anterior spinal instrumentation combining a prosthetic disc nucleus with a flexible stabilization device (ASI combining PDN/FD) was developed. An artificial disc was designed and manufactured using polyvinyl alcohol hydrogel (PVA-H) with a repeated freeze-melting technique, and subsequently the dehydration and swelling properties of the PVA-H were investigated. A canine animal model was then used to compare the differences in the degeneration of cervical discs adjacent to the operative segment with PDN/FD against a plate fixation system, without the interferences of brace intensity, which was ensured by pressure monitoring the dog's intervertebral disc adjacent to operative segments. The results demonstrated a clear decrease in the degeneration of the adjacent disc with the use of PDN/FD as compared with the plate fixation system. In conclusion, PDN/FD may offer a promising method for the treatment of cervical degenerative disease.

摘要

单纯人工椎间盘置换无法完全治愈颈椎退行性疾病;因此,一种稳定装置能显著改善患者的恢复情况。为满足这一需求,研发了一种将人工椎间盘髓核与柔性稳定装置相结合的前路脊柱内固定系统(ASI结合PDN/FD)。使用聚乙烯醇水凝胶(PVA-H)通过反复冻融技术设计并制造了一种人工椎间盘,随后研究了PVA-H的脱水和膨胀特性。然后使用犬类动物模型,在不考虑支具强度干扰的情况下,比较PDN/FD与钢板固定系统对手术节段相邻颈椎间盘退变的差异,这通过对犬类手术节段相邻椎间盘进行压力监测得以确保。结果表明,与钢板固定系统相比,使用PDN/FD时相邻椎间盘的退变明显减轻。总之,PDN/FD可能为治疗颈椎退行性疾病提供一种有前景的方法。

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本文引用的文献

1
Comparison between cervical total disc replacement and anterior cervical discectomy and fusion of 1 to 2 levels from 2002 to 2009.2002 年至 2009 年,1 至 2 节段颈椎前路间盘切除融合与颈椎间盘置换的比较。
Spine (Phila Pa 1976). 2014 Jan 1;39(1):53-7. doi: 10.1097/BRS.0000000000000044.
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Index and adjacent level kinematics after cervical disc replacement and anterior fusion: in vivo quantitative radiographic analysis.颈椎间盘置换和前路融合术后的索引和相邻节段运动学:体内定量放射学分析。
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A clinical analysis of 4- and 6-year follow-up results after cervical disc replacement surgery using the Bryan Cervical Disc Prosthesis.Bryan 颈椎间盘假体置换术后 4 年和 6 年随访的临床分析。
J Neurosurg Spine. 2010 Mar;12(3):261-9. doi: 10.3171/2009.9.SPINE09129.
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Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases.单节段和双节段病例中,ACDF(前路颈椎间盘切除融合术)与Bryan人工椎间盘置换术后影像学变化的比较。
Eur Spine J. 2009 Feb;18(2):218-31. doi: 10.1007/s00586-008-0854-z. Epub 2009 Jan 6.
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Adjacent segment disc pressures following two-level cervical disc replacement versus simulated anterior cervical fusion.
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Intervertebral mobility in the progressive degenerative process. A radiostereometric analysis.进行性退变过程中的椎间活动度。一项放射立体测量分析。
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The relationship between disc degeneration and morphologic changes in the intervertebral foramen of the cervical spine: a cadaveric MRI and CT study.颈椎椎间孔椎间盘退变与形态学改变的关系:一项尸体MRI和CT研究
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Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level.使用Bryan颈椎间盘假体治疗退行性椎间盘疾病后的中期随访:单节段和双节段。
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Magnetic resonance classification of lumbar intervertebral disc degeneration.腰椎间盘退变的磁共振成像分类
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10
Kyphotic malalignment after anterior cervical fusion is one of the factors promoting the degenerative process in adjacent intervertebral levels.颈椎前路融合术后的后凸畸形排列不齐是促进相邻椎间节段退变进程的因素之一。
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