人工颈椎间盘结构、材料及体外生物力学的研究进展

Research progresses of artificial cervical disc structure, material and in vitro biomechanics

背景:人工颈椎间盘置换作为颈椎疾病治疗的全新方法,正逐渐得到临床广泛认可,其使用的植入器械--人工颈椎间盘还需更深入研发及验证。目的:综述了现有人工颈椎间盘产品的结构、材料及体外生物力学研究,并对未来发展状态进行展望。方法:以"artificial cervical disc,prothesis,structure,material,biomechanical study"为英文检索词检索Pubmed数据库,以"人工颈椎间盘,假体,结构,材料,生物力学"为检索词检索CNKI数据库,纳入人工颈椎间盘结构设计、材料设计及体外生物力学评估相关工作,主要整理近5年来有关研究,排除重复性工作,重点对36篇文献进行分析讨论。结果与结论:现有人工颈椎间盘产品主要采用金属-聚合物(MOP)结构,以半限制型和非限制型居多,尺寸系列已较完善,且全为进口产品。通过对现有产品进行分析与总结,提出人工颈椎间盘在新结构设计、面向种群设计和材料改进3个方向有重大发展空间,材料改进可以从终板材料、髓核材料、表面喷涂材料几方面考虑。

BACKGROUND： Artificial cervical disc replacement has been widely used in clinical cervical surgery. Further research of biomechanics of the artificial cervical disc used in the surgery is needed, OBJECTIVE： To review the structure, material types and in vitro biomechanical study of the existed artificial cervical disc, and to prospect the development in the future. METHODS： The PubMed databases and CNKI database were searched with key words of ＂artificial cervical disc prosthesis, structure, material, biomechanical study＂ in English and Chinese respectively. The articles related to artificial cervical disc structure, material, and in vitro biomechanics were included. The researches in the recent 5 years were collected, and the repetitive studies were excluded. A total of 36 articles were discussed for interview RESULTS AND CONCLUSION： The existed cervical artificial disc products mainly use the structure of the metal-polymer, and most are the semi-restrictive and non-restrictive structure, dimension series are more perfect and all of them are the imported products. The analysis and the summary of the existed products show that the cervical artificial disc has major development space in three aspects of structure design, oriented population design and material improvement, and the improvement of the material can be considered from the aspects of ndplate material, nucleus pulposus material and surface coating material.