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球窝型人工腰椎间盘假体研究现状

项顶顶 祝佳 王松 廖振华 刘伟强

项顶顶, 祝佳, 王松, 廖振华, 刘伟强. 球窝型人工腰椎间盘假体研究现状[J]. 仁和测试, 2020, 37(3): 527-532, 540. doi: 10.7507/1001-5515.201909044
引用本文: 项顶顶, 祝佳, 王松, 廖振华, 刘伟强. 球窝型人工腰椎间盘假体研究现状[J]. 仁和测试, 2020, 37(3): 527-532, 540. doi: 10.7507/1001-5515.201909044
Dingding XIANG, Jia ZHU, Song WANG, Zhenhua LIAO, Weiqiang LIU. A review on the current state of ball-on-socket type artificial lumbar disc prosthesis[J]. Rhhz Test, 2020, 37(3): 527-532, 540. doi: 10.7507/1001-5515.201909044
Citation: Dingding XIANG, Jia ZHU, Song WANG, Zhenhua LIAO, Weiqiang LIU. A review on the current state of ball-on-socket type artificial lumbar disc prosthesis[J]. Rhhz Test, 2020, 37(3): 527-532, 540. doi: 10.7507/1001-5515.201909044

球窝型人工腰椎间盘假体研究现状

doi: 10.7507/1001-5515.201909044
基金项目: 国家自然科学基金(51705336);深圳市国际合作项目(GJHZ20180413181811215);深圳市基础研究项目(JCYJ20170816152620649)

A review on the current state of ball-on-socket type artificial lumbar disc prosthesis

Funds: The National Natural Science Foundation of China
  • 摘要: 人工腰椎间盘置换术是治疗椎间盘退行性病变、缓解腰背痛的有效方式。球窝型人工腰椎间盘是最常用的假体类型。本文回顾了球窝型人工腰椎间盘假体的历史,综述了金属—聚合物、金属—金属和聚合物—聚合物不同组合配副的球窝型人工腰椎间盘假体产品现状。结合最新研究进展,分析球窝型人工腰椎间盘假体结构设计因素及影响,并对球窝型人工腰椎间盘假体未来的发展加以展望,以期为设计球窝型人工腰椎间盘假体提供更加全面系统的理论参考。
  • 图  1  人工腰椎间盘假体尺寸标注示意图

    Figure  1.  Size labeling schematic diagram of artificial lumbar disc prosthesis

    表  1  人工腰椎间盘假体产品现状

    Table  1.   Artificial lumbar disc prosthesis product status

    配副 材料 产品 制造商 自由度 关节面 球窝位置 形状 状态
    MoP CoCr-UHMWPE Charité DePuy Synthes Spine,Raynham,MA,USA 5 移动 中间 椭圆形 FDA 批准-2004
    ProDisc-L DePuy Synthes Spine,Raynham,MA,USA 3 固定 中间 D 字形 FDA 批准-2006
    Activ-L Aesculap AG,Tuttlingen,Germany 4 移动 中间 D 字形 FDA 批准-2015
    Mobidisc-L Zimmer Biomet,Warsaw,IN,USA 5 移动 中间 椭圆形
    Ti-PE Baguera-L SpineArt,Geneva,Switzerland 4 或 6 可选 中间 D 字形 未被 FDA 批准
    MoM CoCr-CoCr Maverick Medtronic,Memphis,TN,USA 3 固定 后置 D 字形 IDE 试验完成
    Flexicore Stryker Spine,Allendale,NJ,USA 3 限制 中间 D 字形
    Kineflex Southern Medical(Pty)Ltd.,Irene,South Africa 5 移动 后置 椭圆形 IDE 试验终止
    XL TDR NuVasive,Inc.,San Diego,CA,USA 3 固定 后置 长方形 IDE 试验阶段
    TRIUMPH Globus Medical,Inc.,Audubon,PA,USA 3 固定 后置 长方形 IDE 试验阶段
    PoP PEEK-PEEK InOrbitTM Globus Medical,Inc.,Audubon,PA,USA 3 固定 中间 长方形
    ORBITTM-R Globus Medical,Inc.,Audubon,PA,USA 3 移动 中间 椭圆形
    注:IDE:医疗器械研究性试验豁免(investigational device exemption);PEEK:聚醚醚酮(polyetheretherketone)
    下载: 导出CSV

    表  2  CoCr-UHMWPE 材料配副假体不同的髓核固定方式

    Table  2.   Different ways on core fixation of CoCr-UHMWPE type prosthesis

    产品 UHMWPE 髓核与 CoCr 合金的相对运动
    Charité 髓核自由旋转和滑动
    ProDisc-L 髓核完全固定在下终板
    Activ-L 髓核固定在下终板上,且前后方向可微小移动
    Mobidisc-L 髓核固定在下终板上,且前后左右方向均可微小移动
    下载: 导出CSV

    表  3  不同材料配副的优缺点

    Table  3.   Advantages and disadvantages of different material pairings

    种类 优点 缺点
    MoP 聚合物髓核可以起到缓冲吸振作用 聚合物力学性能不足,易破碎。同时聚合物磨屑会导致
    骨溶解
    MoM 金属的磨损性能好,磨损率低,采用后置旋转中心,可以减小
    小关节应力
    金属离子可引起过敏毒性等反应
    PoP 聚合物弹性模量低,缓冲吸振 同 MoP 配副
    下载: 导出CSV

    表  4  人工腰椎间盘假体产品设计尺寸规格

    Table  4.   Design sizes of artificial lumbar disc prosthesis products

    产品 高度/mm 角度/(°) 型号 长 × 宽/(mm × mm)
    ProDisc-L H1 = 10,12,14 3,6,9,11 M,L 34.5 × 27,39 × 30
    Activ-L H2 = 8.5,10,12,14 6,11,16 S,M,L,XL 31 × 26,34.5 × 28,39 × 30,40 × 33
    Mobidisc-L H1 = 10,11,12,13 5,10 T6,T8(S,M,L) 34 × (27,30,33),39 × (30,33,36)
    Baguera-L h = 8,10,12 5,10 S,M,L 35 × 27,39 × 30,42 × 31
    Maverick H1 = 10,12,14 6,9,12 S,M,L 32 × 25,35 × 27,39 × 30
    下载: 导出CSV

    表  5  人工腰椎间盘假体产品表面生物涂层和固定方式

    Table  5.   Biological coatings and fixation methods of artificial lumbar disc prosthesis products

    产品 表面生物涂层 固定方式
    ProDisc-L 多孔钛 上下 2 个脊骨
    Activ-L 等离子体钛微孔涂层和微米级磷酸钙层 上下共 6 个尖齿
    Mobidisc-L 粗糙钛表面和羟基磷灰石涂层 上下 2 个固定嵌片
    Baguera-L 多孔钛 上下共 10 个尖齿
    Maverick 羟基磷灰石涂层 上下 2 个脊骨
    下载: 导出CSV
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出版历程
  • 收稿日期:  2019-09-18
  • 修回日期:  2020-04-23
  • 刊出日期:  2020-03-17

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