生物力学环境影响颈椎间盘置换术后异位骨化的研究进展

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摘要由于人工颈椎间盘置换术(cervical disc arthroplasty，CDA)在缓解症状和/或神经功能改善的同时，具备保留节段活动、维持椎间盘高度、减轻邻近节段异常的生物应力以及预防邻近节段退变的理论优势，因此，CDA在过去十余年间被确立为治疗颈椎间盘退行性疾病(cervical degenerative disc disease，CDDD)的一种选择。目前，在治疗单节段或双节段CDDD中可作为前路颈椎间盘切除融合术的有效替换方案，显示出安全、满意的短中期、甚至长期效果。
但是，作为CDA术后长期疗效的一个主要因素，异位骨化(heterotopic ossification，HO)的形成和发展极大影响了假体长期的活动功能，还会影响临床症状的改善，甚至消除CDA对邻近节段的保护效应，与邻近节段退行性变密切相关。关于报道CDA术后HO的发生率千差万别，且HO的确切病因仍不清楚。目前有研究提示颈椎内在生物力学状态或应力负荷可能与HO形成有关，且有学者认为间盘假体类型和手术技术可能是影响HO形成和发展的最重要因素，而手术技术和间盘的动力学特点直接与CDA术后颈椎的生物力学环境相关。本文现重点围绕机械应力刺激及生物力学环境变化在HO形成中的作用、从生物力学角度探索预防或减少HO等方面加以综述。

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	胡凌云 1
	2
	刘浩 1*
	孟阳 1
	杨毅 1
	修志刚 3
	王贝宇 1
	丁琛 1

基金资助:国家自然科学基金面上项目(编号：81572141)
市校科研合作项目(编号：18SXHZ0440)

通讯作者: 刘浩

作者简介: 胡凌云(1983－ )，男，副主任医师，四川大学华西医院骨科，610041。

引用本文:

胡凌云 1，2，刘浩 1*，孟阳 1，杨毅 1，修志刚 3，王贝宇 1，丁琛 1. 生物力学环境影响颈椎间盘置换术后异位骨化的研究进展[J]. 实用骨科杂志, 2020, 26(5): 427-431.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2020/V26/I5/427

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