脊柱侧弯矫正融合中新型植骨材料的特点

Characteristics of new-type bone graft materials in scoliosis correction and fusion

背景:随着外科技术的进步,尤其脊柱侧凸矫形手术的推广,对植骨材料提出了更高的要求,要求植骨材料既有成骨活性,又要在结构和机械性能上显示与自然骨类似的特性,同时还要符合生物力学要求。目的:综述脊柱侧弯矫正融合中新型植骨材料的应用进展。方法:应用计算机检索2009至2012年Elsevier全文数据库相关文章,检索词"nano-hydroxyapatite,hydroxyapatite,scoliosis",并限定文章语言种类为English。同时计算机检索同方、知网中国期刊全文数据库相关文章,检索词为"脊柱侧凸,植骨材料,纳米人工骨,骨形态发生蛋白2,人工骨",并限定文章语言种类为中文。最终纳入符合标准的文献27篇。结果与结论:纳米人工骨具有良好的生物相容性及骨传导性,模仿天然骨的成分及结构特征,结构上与自然骨结晶部分基本一致,可为细胞提供与天然骨相类似的微环境。在脊柱外科中骨性融合是脊柱侧凸手术治疗成功的标志之一,植骨材料的来源一直困扰着脊柱外科医生。寻找一种能形成骨性融合又具有成骨活性的材料是目前国内外研究的热点,纳米人工骨在脊柱外科的应用展现了广阔的前景。

BACKGROUND： With the advances in surgical techniques, especially the promotion of scoliosis operation, the bone graft material has put forward higher requirements. Bone grafting material should not only have osteogenic activity, but also display similar characteristic on the structure and mechanical properties of natural bone, and meet the biomechanical requirements. OBJECTIVE： To review the application progresses of new-type bone graft materials in scoliosis correction and fusion. METHODS： Elsevier full-text database was retrieved by computer for relevant articles （2009-2012） with the key words of ＂non-hydroxyapatite, hydroxyapatite, scoliosis＂ in English. At the same time the HowNet and China Journal Full-text databases were searched for relevant articles with the key words of ＂scoliosis, bone graft material, nano artificial bone, bone morphogenetic protein 2, artificial bone＂ in Chinese. Totally 27 articles were included. RESULTS AND CONCLUSION： Nano artificial bone has excellent biocompatibility and bone conduction. It imitates the component and structure characteristic of natural bone. Besides, its structure is basically the same with the natural bone crystals part to provide a microenvironment which is similar to natural bone. In spine surgery, bony fusion is a marker of successful treatment of scoliosis surgery. However, spine surgeons have been puzzled by the source of bone graft materials. So the hot spots at home and abroad are looking for bone repair materials that cannot only form bone fusion but also have osteogenic activity. Nano artificial bone shows a broad prospect in the application of spinal surgery.