Motion-preserving technologies for degenerative lumbar spine: The past, present, and future horizons.
Motion-preserving technologies for degenerative lumbar spine: The past, present, and future horizons.
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DOI：
10.1016/j.esas.2011.05.001
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发表时间：
2011-01-01
期刊：
影响因子：
--
通讯作者：
Bono, Christopher M
中科院分区：
文献类型：
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作者：
Serhan, Hassan;Mhatre, Devdatt;Bono, Christopher M
在过去的几十年里，在了解腰痛和腰椎疾病的起源方面取得了显着的进步。脊柱融合通常被认为是治疗腰痛的“金标准”;然而，融合也与相邻节段的加速退变有关。脊柱关节成形术和动态稳定技术，以及诊断和手术干预的不断改进，开辟了治疗选择的新时代。非融合技术的最新进展，如运动保留装置和后路动态稳定可能会改变金标准。这些器械旨在提供稳定性并消除疼痛，同时保持功能性脊柱单位的活动。手术界和支付者对非融合技术的适应性将取决于对照随机临床研究的长期临床结局。虽然非融合技术的发展才刚刚开始，采用非常缓慢，但它可能被认为是未来几年运动保留的可行选择。这篇综述文章提供了过去和现在的技术和手术观点，以及对腰椎疾病器械开发的未来努力和挑战的一瞥。© 2011 SAS -国际脊柱外科促进协会。爱思唯尔公司出版All rights reserved.
Over the past few decades, remarkable advancements in the understanding of the origin of low-back pain and lumbar spinal disorders have been achieved. Spinal fusion is generally considered the "gold standard" in the treatment of low-back pain; however, fusion is also associated with accelerated degeneration of adjacent levels. Spinal arthroplasty and dynamic stabilization technologies, as well as the continuous improvement in diagnosis and surgical interventions, have opened a new era of treatment options. Recent advancements in nonfusion technologies such as motion-preservation devices and posterior dynamic stabilization may change the gold standard. These devices are designed with the intent to provide stabilization and eliminate pain while preserving motion of the functional spinal unit. The adaption of nonfusion technologies by the surgical community and payers for the treatment of degenerative spinal conditions will depend on the long-term clinical outcome of controlled randomized clinical studies. Although the development of nonfusion technology has just started and the adoption is very slow, it may be considered a viable option for motion preservation in coming years. This review article provides technical and surgical views from the past and from the present, as well as a glance at the future endeavors and challenges in instrumentation development for lumbar spinal disorders. © 2011 SAS - The International Society for the Advancement of Spine Surgery. Published by Elsevier Inc. All rights reserved.