Biomechanical Assessment of Nucleus Replacement Devices

核替代装置的生物力学评估

• 批准号: 2290113
• 金额: --
• 依托单位: Imperial College London
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2019
• 资助国家: 英国
• 起止时间: 2019 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2290113
• 关键词: Biomechanical; Assessment; Nucleus; Replacement; Devices

Globally, low back pain is the leading cause of disability with a lifetime risk of 75%. It is estimated to cost £500 million to the NHS annually, and there is a strong association between low back pain and degeneration of the intervertebral discs (IVDs) that lie between vertebra in the spine. In patients who have a degree of IVD degeneration that is not severe enough to warrant total disc replacement or fusion, but sufficient pain to warrant surgery, nucleus (partial IVD) replacement is an alternative, less invasive, treatment.Currently nucleus replacement devices (usually a hydrogel), are surgically inserted into the IVD through the annulus fibrosus (AF) that surrounds the nucleus. A common complication with this approach is that over time, the device is squeezed back out through the hole made in the AF. It is hypothesised that changes in the surgical approach, materials used, and design of the nucleus replacement will enhance its biomechanical performance, however, there is currently no standardised method to scientifically assess the performance of different nucleus replacement designs.This project aims to develop a rigorous testing protocol that allows the effect of changing the design of the nucleus replacement (for example materials, surgical approach, design concepts) on the response of a motion segment to be quantified and compared.

在全球范围内，腰痛是导致残疾的主要原因，其终生风险为75%。据估计，英国国家医疗服务体系每年要花费5亿英镑，腰痛和脊柱椎体之间的椎间盘退变之间有很强的联系。对于IVD退变程度不严重到需要全椎间盘置换术或融合术，但疼痛程度足以需要手术的患者，核（部分IVD）置换术是另一种侵入性较小的治疗方法。目前，核替代装置（通常是水凝胶）通过手术通过环绕核的纤维环（AF）插入IVD。该方法的一个常见并发症是，随着时间的推移，器械会从心房孔中挤出。假设手术入路、使用的材料和核置换设计的变化将提高其生物力学性能，然而，目前还没有标准化的方法来科学评估不同核置换设计的性能。该项目旨在制定一个严格的测试方案，允许改变核置换设计（例如材料，手术方法，设计概念）对运动段响应的影响进行量化和比较。