Viswanathan Vibhu Krishnan, Rajaram Manoharan Sakthivel Rajan, Subramanian Surabhi, Moon Andrew
Department of Surgery, IWK Hospital, Halifax, Nova Scotia, Canada.
Department of Orthopedic Surgery, University of Alabama, Birmingham, Alabama, USA.
World Neurosurg. 2019 Mar;123:142-155. doi: 10.1016/j.wneu.2018.11.035. Epub 2018 Nov 14.
Nanotechnology is a promising field with numerous applications across various branches of medicine. The unique innate physical, chemical, and biological properties of nanoparticles enable them to serve as appropriate agents performing diverse functions at cellular and subcellular levels. Spinal pathologies constitute one major field where its applications are being explored.
A critical review of literature was performed to identify the current role of nanotechnology in spine surgery. A PubMed search was done using the following key words: "nanotechnology in neurosurgery," "nanotechnology in surgery," "nanotechnology in spine," "nanotechnology in spine surgery," "nanotechnology in disc regeneration," "nanotechnology in spinal injury," "nanotechnology in spinal cord regeneration," "nanotechnology in spine fusion," "nanotechnology in osteoporosis," "nanotechnology in spinal drug delivery," and "nanotechnology in spinal infection." Initial search revealed 347 articles. Articles were further screened. Duplicate articles, articles on nonnanotechnologic topics, nonspine articles, or articles with details not pertaining to the current field of interest and non-English language studies were excluded.
A total of 76 articles were finally included. Nanotechnologic advancements in spine surgery include applications in spinal fusion, central nervous system drug delivery, neuronal regeneration, disk regeneration, spinal infection prophylaxis, management of osteoporosis, sutureless vascular anastomosis, molecular imaging, and theranostic medicine.
Nanotechnology in spine surgery is still in its early stages. Eventually, we may see the implementation of nanotechnology as an alternative to existing treatment options. Concerns regarding safety of this technology need to be addressed through future research projects. Although promising, the exact role of nanotechnology in spine surgery remains to be seen.
纳米技术是一个前景广阔的领域，在医学的各个分支都有众多应用。纳米颗粒独特的物理、化学和生物学固有特性使其能够作为合适的媒介，在细胞和亚细胞水平发挥多种功能。脊柱疾病是正在探索其应用的一个主要领域。
对文献进行批判性综述，以确定纳米技术在脊柱外科手术中的当前作用。使用以下关键词在PubMed上进行搜索：“神经外科中的纳米技术”、“外科手术中的纳米技术”、“脊柱中的纳米技术”、“脊柱外科手术中的纳米技术”、“椎间盘再生中的纳米技术”、“脊髓损伤中的纳米技术”、“脊髓再生中的纳米技术”、“脊柱融合中的纳米技术”、“骨质疏松症中的纳米技术”、“脊柱药物递送中的纳米技术”以及“脊柱感染中的纳米技术”。初步搜索显示有347篇文章。对文章进行进一步筛选。排除重复文章、关于非纳米技术主题的文章、非脊柱文章、或细节与当前感兴趣领域无关的文章以及非英语语言研究。
最终共纳入76篇文章。脊柱外科手术中的纳米技术进展包括在脊柱融合、中枢神经系统药物递送、神经元再生、椎间盘再生、脊柱感染预防、骨质疏松症管理、无缝合血管吻合、分子成像和治疗诊断医学等方面的应用。
脊柱外科手术中的纳米技术仍处于早期阶段。最终，我们可能会看到纳米技术作为现有治疗选择的替代方案得到应用。需要通过未来的研究项目来解决对该技术安全性的担忧。尽管前景广阔，但纳米技术在脊柱外科手术中的确切作用仍有待观察。
