“灯笼骨架形”记忆合金椎体成形架的生物学特性

Biological properties of "Lantern skeleton-shaped" memory alloy vertebroplasty frame

目的:介绍自行研制用于治疗胸腰椎压缩骨折的"灯笼骨架形"记忆合金椎体成形架的研制理念及其生物学特性。方法:由第一作者在万方数据库、中文科技期刊数据库、中国生物医学数据库中检索1999-01/2009-12有关生物材料应用于老年骨质疏松性胸腰椎压缩骨折的研究文章,关键词为"胸腰椎压缩骨折,生物材料,椎体后凸成形术"。分析总结出目前治疗老年骨质疏松胸腰椎压缩骨折材料存在的一些不足以及理想材料应具备的条件,从而作者提出设计一种用于治疗骨质疏松胸腰椎压缩骨折较理想的新型材料的构想。结果:经检索共查到相关文献60余篇,排除筛选后纳入31篇文献进行评价。结果提示,治疗胸腰椎压缩骨折理想的材料应具备无毒、能微创置入、置入过程安全简捷、扩张均匀以及具有足够的复张力及抗压支撑力的条件;参照以上条件,作者根据国人胸腰椎矢状径大小,自行研制出"灯笼骨架形"记忆合金椎体成形架,并根据实验的应用效果加以改良,其小、中、大号(长度分别为22,26,30mm)记忆合金椎体成形架已能基本满足国人下胸椎与腰椎压缩骨折治疗要求。结论:"灯笼骨架形"记忆合金椎体成形架具备能够经椎弓根双向微创置入、安全、扩张均匀、具有足够的复张力及抗压支撑力的优点,早期支架的弹性固定支撑以及后期植入支架内的人工骨粉与自身椎体相融合形成的生物学固定支撑更能满足椎体生物学性能要求,同时可以避免椎体后凸成形术骨水泥渗漏等并发症,具有较好的临床应用开发前景。

OBJECTIVE： To introduce development concept and biological characteristics of the ＂lantern skeleton-shaped＂ memory alloy vertebroplasty frame to treat thoracolumbar vertebral compression fractures. METHODS： A computer-based online search of Wanfang, VIP and CMB databases was performed for articles published between January 1999 and December 2009 related to osteoporotic thoracolumbar vertebral compression fracture in the elderly with key words ＂thoracolumbar vertebral compression fracture, biomaterial, kyphoplasty＂. Insufficiency in the material and conditions in the osteoporotic thoracolumbar vertebral compression fracture in the elderly was analyzed, and an ideal novel material should be designed. RESULTS： A total of 60 relevant literatures were collected, and 31 were included. Results show that ideal material should be non-toxic and can be minimally invasive implanted, with security, uniform expansion, sufficient expansion force and compression support force. According to the above conditions, ＂Lantern skeleton-shaped＂ memory alloy vertebroplasty frame was developed based on Chinese thoracolumbar sagittal diameter. Moreover, it is improved according to observation experimental effects. The small, medium and large （length 22 mm, 26 mm and 30 mm） ＂Duckbill-shaped＂ memory alloy vertebroplasty frame can be able to meet treatment requirements of the Chinese thoracolumbar compression fracture. CONCLUSION： ＂Lantern Skeleton-shaped＂ memory alloy vertebroplasty frame has advantages such as minimal invasion implantation through pedicle, security, uniform expansion, with sufficient expansion force and compression support force. It can meet requirement of spinal biological properties because of early elastic fixation and later biological fixation through artificial bone and vertebral fusion. Moreover, it can avoid some percutaneous kyphoplasies complications such as bone cement leakage and has better clinical application development prospects.