金属椎弓根螺钉植入物及其新型替代材料的研究与进展

The advance in metal pedicle screw and its alternative biomaterials

背景:椎弓根螺钉内固定系统广泛应用于脊柱骨折、退行性变、肿瘤等疾病之中,螺钉的材料、整体设计及结合新型生物材料强化等方面的研究有了很大进展。目的:对国内外椎弓根螺钉的设计进展作一综述。方法:由第一作者检索1994/2010中国期刊全文数据库及1959/2010 Pubmed数据库中关于椎弓根螺钉的文章,在标题和摘要中以"椎弓根螺钉,生物力学,设计,生物材料"或"pedicle screw,biomechanics,design,biomaterial"为检索词进行检索。选择文章内容与椎弓根螺钉设计有关者,同一领域文献则选择近期发表或发表在权威杂志文章。最终入选36篇文献进入结果分析。结果与结论:采用钛合金材料,增加螺钉的直径及长度,使用特殊设计的螺钉,如可膨胀椎弓根螺钉,或运用生物材料强化椎弓根螺钉,可以提高螺钉的固定强度。此外,不同螺钉形状、螺纹形状、螺纹倾角、螺纹深度、间距与其固定强度密切相关。设计螺钉时应充分考虑到各个因素,以便于研究出更完美的椎弓根螺钉。

BACKGROUND：Pedicle screw fixation systems are widely used in spinal fractures,degeneration diseases,cancer and other diseases,the materials,design of pedicle screws and biomaterials are in the great development. OBJECTIVE：To summarize the investigative situation and progression about design of pedicle screws at home and abroad. METHODS：Databases of CNKI（1994/2010） and PubMed（1959/2010） were selected to search the related articles about pedicle screws with of ＂pedicle screw,biomechanics,design and biomaterial＂ in Chinese and English. Then,36 articles related to pedicle screws were included in result analysis. RESULTS AND CONCLUSION：Using Titanium system,increased diameter and length of screws,special pedicle screws such as expendable screws,and pedicle screws augmentation with biomaterials can improve fixation rigidity. Besides,screw shape,thread shape,inclination angle,thread depth and pitch are closely related with fixation rigidity of pedicle screws. We should take more factors into considerations to design more reasonable pedicle screws.