脊柱植入物中的生物材料:综述
Biomaterials in Spinal Implants: A Review.
作者信息
Warburton Andrew, Girdler Steven J, Mikhail Christopher M, Ahn Amy, Cho Samuel K
机构信息
Mount Sinai Health System, New York, NY, USA.
出版信息
Neurospine. 2020 Mar;17(1):101-110. doi: 10.14245/ns.1938296.148. Epub 2019 Nov 4.
The aim to find the perfect biomaterial for spinal implant has been the focus of spinal research since the 1800s. Spinal surgery and the devices used therein have undergone a constant evolution in order to meet the needs of surgeons who have continued to further understand the biomechanical principles of spinal stability and have improved as new technologies and materials are available for production use. The perfect biomaterial would be one that is biologically inert/compatible, has a Young's modulus similar to that of the bone where it is implanted, high tensile strength, stiffness, fatigue strength, and low artifacts on imaging. Today, the materials that have been most commonly used include stainless steel, titanium, cobalt chrome, nitinol (a nickel titanium alloy), tantalum, and polyetheretherketone in rods, screws, cages, and plates. Current advancements such as 3-dimensional printing, the ProDisc-L and ProDisc-C, the ApiFix, and the Mobi-C which all aim to improve range of motion, reduce pain, and improve patient satisfaction. Spine surgeons should remain vigilant regarding the current literature and technological advancements in spinal materials and procedures. The progression of spinal implant materials for cages, rods, screws, and plates with advantages and disadvantages for each material will be discussed.
自19世纪以来,寻找用于脊柱植入物的完美生物材料一直是脊柱研究的重点。脊柱手术及其所用器械不断发展,以满足外科医生的需求,他们不断深入理解脊柱稳定性的生物力学原理,并随着新技术和新材料可供生产使用而不断改进。完美的生物材料应具有生物惰性/相容性,其杨氏模量与植入部位的骨骼相似,具有高拉伸强度、刚度、疲劳强度,且在成像时伪影少。如今,最常用的材料包括不锈钢、钛、钴铬合金、镍钛诺(一种镍钛合金)、钽以及用于棒、螺钉、椎间融合器和钢板的聚醚醚酮。当前的进展,如三维打印、ProDisc-L和ProDisc-C、ApiFix以及Mobi-C,所有这些都旨在改善活动范围、减轻疼痛并提高患者满意度。脊柱外科医生应密切关注脊柱材料和手术的当前文献及技术进展。本文将讨论椎间融合器、棒、螺钉和钢板等脊柱植入材料的发展历程,以及每种材料的优缺点。
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