CAJ | 학술논문

背景：传统“金标准”颈前路减压植骨融合及近年来迅速发展的人工颈椎间盘置换是临床上常见的治疗颈椎病的方式。大量科研工作者和临床医生希望通过颈椎体外标本实验研究脊柱生物力学，为临床治疗提供指导数据。 　　目的：对现有颈椎体外标本生物力学实验研究进展进行综述，并对未来的研究方向进行展望。 　　方法：以“Cervical Spine, Fusion, Replacement, Hybrid, Biomechanics, In vitro, Adjacent-level Degeneration, Review”为英文检索词检索Pubmed数据库，以“颈椎，融合，置换，混合术，生物力学，体外，相邻节段退变，综述”为检索词检索CNKI数据库和万方数据库，检索2007年1月至2013年3月有关颈椎前路融合与置换体外生物力学实验研究进展的文献，主要整理近3年来相关研究，排除陈旧文章和重复性工作，最后对40篇文献进行归纳与讨论。 　　结果与结论：文章对现有的颈椎体外标本融合、置换实验进行总结，集中体现在手术多节段、运动控制条件差异化、颈椎耦合运动测试和新型植入器械4个方面，对比总结融合与置换治疗对邻近节段运动范围、关节内压力、髓核内压力和椎间孔形态的影响，探讨融合、置换后存在的问题。最后结合临床的需求，展望颈椎体外标本实验的发展趋势及应用前景。
배경：전통“금표준”경전로감압식골융합급근년래신속발전적인공경추간반치환시림상상상견적치료경추병적방식。대량과연공작자화림상의생희망통과경추체외표본실험연구척주생물역학，위림상치료제공지도수거。 　　목적：대현유경추체외표본생물역학실험연구진전진행종술，병대미래적연구방향진행전망。 　　방법：이“Cervical Spine, Fusion, Replacement, Hybrid, Biomechanics, In vitro, Adjacent-level Degeneration, Review”위영문검색사검색Pubmed수거고，이“경추，융합，치환，혼합술，생물역학，체외，상린절단퇴변，종술”위검색사검색CNKI수거고화만방수거고，검색2007년1월지2013년3월유관경추전로융합여치환체외생물역학실험연구진전적문헌，주요정리근3년래상관연구，배제진구문장화중복성공작，최후대40편문헌진행귀납여토론。 　　결과여결론：문장대현유적경추체외표본융합、치환실험진행총결，집중체현재수술다절단、운동공제조건차이화、경추우합운동측시화신형식입기계4개방면，대비총결융합여치환치료대린근절단운동범위、관절내압력、수핵내압력화추간공형태적영향，탐토융합、치환후존재적문제。최후결합림상적수구，전망경추체외표본실험적발전추세급응용전경。
BACKGROUND:Traditional“gold standard”of anterior cervical decompression with fusion and artificial cervical disc replacement rapidly developed in recent years are common clinical methods for the treatment of cervical spondylosis. A large number of researchers and clinicians hope to research the biomechanics of spine through cervical specimen in vitro experiments, which provide guidance for clinical surgery. OBJECTIVE:To review the cervical specimen in vitro experiments and to prospect the future research. METHODS:The PubMed database, CNKI database and Wanfang database were retrieved with the key words of“cervical spine, fusion, replacement, hybrid, biomechanics, in vitro, adjacent-level degeneration, review”in English and Chinese. The articles in the past 3 years on the in vitro biomechanical experiments of anterior cervical fusion and replacement from January 2007 to March 2013 were included. The old and repetitive articles were excluded. Final y, a total of 40 articles were included for review. RESULTS AND CONCLUSION:This article reviewed the in vitro cervical specimen fusion and replacement experiments, and introduced major progress in multi-level, motion control condition differences, cervical coupled motion test and newly designed implant device. The effects of fusion and replacement on adjacent-level range of motion, intra-articular pressure, pressure inside nucleus pulposus and intervertebral foramen morphology were compared to discuss the problems after fusion and replacement, and thus prospecting the development and application of in vitro cervical specimen experiments based on the clinical requirements.