椎间盘退变的生物学治疗研究进展

The research progress in the biological treatment of intervertebral disc degeneration

椎间盘退变是导致慢性腰痛最常见的原因,也是成年人致残的主要原因。由于缺乏有效的治疗手段,椎间盘退变一般表现为迁延不愈,造成严重的经济和社会负担。椎间盘退变是多因素共同作用的结果,随年龄增长发病率逐年增加。机械创伤、遗传因素、生活方式以及代谢障碍等与椎间盘退变的发生密切相关。目前主要的治疗方式包括药物治疗和手术治疗,均以缓解症状、改善功能为目的,不能从根本上逆转椎间盘退变的进程,远期疗效并不理想。生物学疗法理论上不仅能够在一定程度上逆转或延缓椎间盘退变的进程,而且能够最大限度地保留和恢复椎间盘正常的生理功能,是近年来的研究热点。抑制炎症反应、促进残存细胞增殖分裂、干细胞移植、细胞支架及新型生物材料的研发都为椎间盘退变的治疗提供了新的思路和方向。本文就椎间盘退变的干细胞疗法、细胞因子疗法、基因疗法以及组织工程和细胞支架治疗进行综述。

Intervertebral disc degeneration is the most common cause of chronic low back pain and the leading cause of disability in adults.The fact that lacking of effective treatment methods often causes a serious economic and social burden.Intervertebral disc degeneration is the result of multifactorial factors.The prevalence of intervertebral disc degeneration increases drastically with age,what is more,mechanical trauma,genetic predisposition,lifestyle factors and certain metabolic disorders.At present,the main treatment methods both pharmacological and surgical interventions just aim at relieving symptoms and improving function,and can not fundamentally reverse the process of intervertebral disc degeneration,which not only bring inevitable side effects and high cost,but also the long-term curative effect is limited.In theory,biological therapy can not only reverse or delay the process of it,but also can maximize preservation and restore the normal physiological function of the disc,which has been the focus and hot spot areas of research in recent years.The methods of inhibiting inflammation,promote the proliferation and division of residual cells,stem cell transplantation,cell scaffolds and new biomaterials all provide new ideas and direction for the treatment of intervertebral disc degeneration.This paper makes a review of the research progress in related fields,in order to provide a valuable reference for the selection of intervertebral disc degeneration treatment options.