老年脊柱融合术3D打印内植物的新理念与新技术

New concept and technology of 3D-printed implant for spinal fusion in elderly patients

我国人口老龄化形势严峻,脊柱退变性疾病则是威胁老年人群健康和生活质量的一大常见病,近年来需要接受脊柱手术的老年甚至高龄患者也越来越多。虽然各种药物、理疗康复以及微创手术治疗技术在快速发展,但仍有相当一部分的老年脊柱退变患者需要接受“终极”的手术方案——脊柱融合术。老年患者骨质疏松,骨强度差,骨愈合慢,融合手术后出现融合器下沉,螺钉松动、融合内固定失败等风险较高。

Although spinal fusion is a basic and routine technique in spinal surgery,there are still great challenges to achieve stable bone graft fusion in elderly patients with spinal degeneration.New technologies and concepts are needed for break through.3D printing technology enables morphological matching for spine surgical implant design and processing.Furthermore,clinical and scientific practitioners have promoted the development of biological matching orthopedic implants,including tissue matching(microstructural modification and improvement),biomechanical matching(SDS theory),and degradation matching(bioactive materials),while the three directions are mutually inclusive and progressive.Biological matching spine implant development in China started relatively late,however,we are still making breakthroughs in many key technical points and approaching the top level in clinical translation.These achievements may help improve the prognosis of spinal fusion in aging spine.Meanwhile,there is still a gap between the current achievements and the widespread application of biological matching spine surgical implants.Further works are required in the future.