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颈椎手术中使用各种类型椎间融合器的优缺点。文献综述

Advantages and Disadvantages of the Use of Various Types of Interbody Implants in Cervical Spine Surgery. Critical Review of the Literature.

作者信息

Godlewski Bartosz, Dominiak Maciej

机构信息

Szpital św. Rafała w Krakowie, Polska / St. Raphael Hospital in Cracow, Poland Oddział Kliniczny Ortopedii i Traumatologii Narządu Ruchu z Pododdziałem Chirurgii Kręgosłupa. Scanmed / Department of Orthopaedics and Musculoskeletal Traumatology, with Spinal Surgery Ward. Scanmed.

出版信息

Ortop Traumatol Rehabil. 2020 Aug 31;22(4):213-220. doi: 10.5604/01.3001.0014.3457.

Abstract

BACKGROUND

Most cervical spine procedures in patients with degenerative disc disease involve discectomy and remo-val of osteophytes in posterior vertebral body surfaces followed by interbody stabilisation with an interbody implant. Interbody implants are made of a variety of materials, differing in structural design, shape and surface topography. Considering that fusion between the implant and host bone is crucial for long-term positive outcomes, the choice of an appropriate implant is significantly important clinically and continues to be an important area of study.

MATERIAL AND METHODS

Relevant published studies indexed by Medline were identified via PubMed and reviewed. The findings were combined with the authors' experiences. The database query was based on keywords related to implants in cervical spine surgery. This article presents the currently most popular types of implants by describing their properties and indicating their strengths and weaknesses as well as differences between different implant types.

RESULTS

Currently, the most popular interbody cages in cervical spine surgery are polyetheretherketone (PEEK) im-plants, titanium-coated PEEK implants and titanium implants. Besides the type of material used, the shape and surface structure of an implant appear to be of significant importance for a successful bony fusion.

CONCLUSIONS

  1. 3D printing and the ability to produce 3-dimensional porous-surfaced implants opens up considerable pro-spects for this technique in the production of modern interbody implants. 2. Implants that facilitate the engagement (interlocking) of greater volumes of bone (e.g. porous implants) offer better implant fixation, with the type of material used being less important.
摘要

背景

大多数退行性椎间盘疾病患者的颈椎手术包括椎间盘切除术、去除椎体后表面的骨赘,随后使用椎间融合器进行椎间稳定。椎间融合器由多种材料制成,在结构设计、形状和表面形貌方面存在差异。鉴于融合器与宿主骨之间的融合对于长期良好预后至关重要,选择合适的融合器在临床上具有重要意义,并且仍然是一个重要的研究领域。

材料与方法

通过PubMed检索Medline索引的相关已发表研究并进行综述。研究结果结合了作者的经验。数据库查询基于与颈椎手术中融合器相关的关键词。本文通过描述目前最流行的融合器类型的特性、指出其优缺点以及不同类型融合器之间的差异来进行阐述。

结果

目前,颈椎手术中最流行的椎间融合器是聚醚醚酮(PEEK)融合器、钛涂层PEEK融合器和钛融合器。除了所使用的材料类型外,融合器的形状和表面结构对于成功的骨融合似乎也非常重要。

结论

  1. 3D打印以及生产三维多孔表面融合器的能力为该技术在现代椎间融合器生产中开辟了广阔前景。2. 能够促进更大体积骨的嵌合(互锁)的融合器(例如多孔融合器)提供了更好的融合器固定效果,所使用材料的类型则不太重要。

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