脊柱非融合技术新进展(英文)

第一作者:张宇鹏

2013-08-02 点击量:600   我要说

Spinal fusion has been the golden standard in the treatment of spinal degenerative disease. However, varied related complications make surgeons look for alternative methods. The proposal and application of the concept of non-fusion technique have made a great effect on the development of spine surgery, which includes prosthetic disc nucleus replacement, total disc replacement, pedicle fixation-based dynamic stabilization devices, interspinous process spacers and facet joint replacement devices. This article has retrospectively summarized the latest research. Prosthetic disc nucleus replacement is not recommended due to the early complications. Total disc replacement can be used to restore the intervertebral height to some extent so as to avoid complications related to spine fusion operation, whereas high-quality clinical research is lacked. Pedicle fixation-based dynamic stabilization devices have been focused on, including the Graf ligament system and Dynesys system, and earlier research has shown good clinical results. However, recently more attention is paid to the complications, and the research conclusions vary, furthermore, even are opposite. Until now the definite conclusion can hardly be drawn. Interspinous process spacers mainly include X-STOP and Wallis, which can lower the occurrence rate of adjacent segment degeneration to some extent. However, the latest research has pointed many complications, and interspinous process spacers should be used carefully. As to facet joint replacement devices, the lack of laboratory research and the difficulties in revision have limited their usages.

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