Ge Rile, Liu Chenjun, Zhao Yuhong, Wang Kaifeng, Wang Xiluan
Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong An Rd, Beijing 100050, China.
Department of Spinal Surgery, Peking University People's Hospital, 11th Xizhimen South Ave., Beijing 100044, China.
J Pers Med. 2024 Sep 9;14(9):957. doi: 10.3390/jpm14090957.
Degenerative scoliosis (DS), encompassing conditions like spondylolisthesis and spinal stenosis, is a common type of spinal deformity. Lumbar interbody fusion (LIF) stands as a conventional surgical intervention for this ailment, aiming at decompression, restoration of intervertebral height, and stabilization of motion segments. Despite its widespread use, the precise mechanism underlying spinal fusion remains elusive. In this review, our focus lies on endochondral ossification for spinal fusion, a process involving vertebral development and bone healing. Endochondral ossification is the key step for the successful vertebral fusion. Endochondral ossification can persist in hypoxic conditions and promote the parallel development of angiogenesis and osteogenesis, which corresponds to the fusion process of new bone formation in the hypoxic region between the vertebrae. The ideal material for interbody fusion cages should have the following characteristics: (1) Good biocompatibility; (2) Stable chemical properties; (3) Biomechanical properties similar to bone tissue; (4) Promotion of bone fusion; (5) Favorable for imaging observation; (6) Biodegradability. Utilizing cartilage-derived bone-like constructs holds promise in promoting bony fusion post-operation, thus warranting exploration in the context of spinal fusion procedures.
退行性脊柱侧凸(DS)包括腰椎滑脱和椎管狭窄等病症,是一种常见的脊柱畸形类型。腰椎椎间融合术(LIF)是针对这种疾病的一种传统手术干预方法,旨在实现减压、恢复椎间高度以及稳定运动节段。尽管其应用广泛,但脊柱融合的确切机制仍不清楚。在本综述中,我们关注的是用于脊柱融合的软骨内成骨,这一过程涉及椎体发育和骨愈合。软骨内成骨是椎体成功融合的关键步骤。软骨内成骨在缺氧条件下可持续存在,并促进血管生成和成骨的平行发展,这与椎体间缺氧区域新骨形成的融合过程相对应。椎间融合器的理想材料应具有以下特性:(1)良好的生物相容性;(2)稳定的化学性质;(3)与骨组织相似的生物力学性质;(4)促进骨融合;(5)有利于影像学观察;(6)可生物降解性。利用软骨衍生的骨样构建体有望促进术后骨融合,因此值得在脊柱融合手术中进行探索。
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