椎间盘纤维环修复的研究与进展

Research and advance in intervertebral disc annulus fibrosus repair

背景:腰椎间盘突出症是临床的常见病,其发病率有逐年增加趋势,严重影响患者的生活质量,给患者家庭及社会带来巨大的经济损失。目前认为椎间盘纤维环完整性的破坏是腰椎间盘突出症发生发展的重要影响因素,因此恢复纤维环的完整性对于腰椎间盘突出症的治疗与预防具有重要意义。目的:旨在综述近年来椎间盘纤维环修复的研究进展。方法:系统检索PubMed数据库、Web of science、中国知网(CNKI)、万方数据库,以“椎间盘、纤维环、修复再生、intervertebral disc annulus fibrosus、repair、regeneration”为关键词,收集各数据库近5年发表的相关文献。结果与结论:近年来国内外关于纤维环修复与再生的研究取得了一定进展,传统的物理修复虽有不足之处,但仍是临床治疗的主要方式,而组织工程应用于纤维环修复目前仅停留于试验阶段,还未广泛应用于临床。椎间盘纤维环修复的方法众多,但最佳的修复策略仍需要大量的动物实验及临床试验来验证其安全性和有效性,利用组织工程技术进行纤维环修复的研究具有广阔的临床应用前景。

BACKGROUND:Lumbar intervertebral disc herniation is a common clinical disease.Its incidence is increasing year by year,which seriously affects the quality of life of patients and brings huge economic losses to the families of patients and society.At present,it is considered that the destruction of the integrity of intervertebral disc fibrous annulus is an important factor affecting the occurrence and development of lumbar disc herniation.Therefore,it is of great significance to restore the integrity of the annulus fibrosus for the treatment and prevention of lumbar disc herniation.OBJECTIVE:To review the research advance in intervertebral disc annulus repair in recent years.METHODS:PubMed,Web of Science,China National Knowledge Infrastructure(CNKI),and WanFang databases were searched systematically,with the key words“intervertebral disc,annulus fibrosus,repair,regeneration”in Chinese and English.Relevant articles published in each database in the last five years were collected.RESULTS AND CONCLUSION:In recent years,some progress has been made in the repair and regeneration of annulus fibrosus in and outside China.Although traditional physical repair has some shortcomings,it is still the main way of clinical treatment,while the application of tissue engineering in annulus fibrosus repair is only in the experimental stage and has not been widely used in clinical practice.There are many ways to repair intervertebral disc annulus fibrous,but the best way needs extensive animal and clinical trials to verify its safety and efficacy.The study on tissue engineering of annulus fibrosus repair has broad clinical application prospects.