Novel Polymeric Scaffolds for Less Invasive Reconstruction of Metastatic Spine Segments

项目摘要 癌症转移到骨性脊柱的识别使治疗的临床医生有义务做出 手术决定。如果脊柱被认为不稳定，有骨折的风险，那么患者将接受主要的 脊椎手术，通常会花掉他们余生的大部分时间来进行康复。椎体 转移瘤有时需要通过椎体和邻近椎间的椎体切除术来治疗。 椎间盘，造成不包含的骨缺损，需要前柱脊柱重建和后路脊柱重建 仪器仪表。需要前路手术暴露的重建技术(重建 受影响的椎骨)和后部暴露(脊柱内固定)对这些患者来说是非常有侵入性的， 而仅限于后路的手术入路需要小型植入物进行脊柱前路重建。 椎间可扩展钛笼，虽然对这种重建有效，但价格昂贵，而且可以 是脊柱重建手术的主要费用。此外，它们通常太大而无法 从后路手术入路安全地插入。因此，迫切需要为这些虚弱的患者提供 较低的手术负担，同时提高他们的生活质量。这项研究提案旨在 解决与脊柱转移性缺陷患者的护理有关的关键问题。这项提案的目标是 是开发一种新的可扩展的生物材料系统，可以通过仅限后部的手术输送 方法，将为脊柱提供刚性和稳定性，并将比目前的成本效益高得多 可膨胀金属保持架

Project Summary The identification of cancer metastases to the bony vertebral column obligates the treating clinician to make a surgical decision. If the spine is deemed unstable and at risk for fracture, then the patient will undergo a major spinal operation, and will often spend much of their remaining life recuperating from it. Vertebral body metastasis is sometimes treated with corpectomy of the affected vertebral body and adjacent intervertebral discs, creating a non-contained skeletal defect needing anterior column spinal reconstruction and posterior instrumentation. Reconstructive techniques requiring both an anterior surgical exposure (reconstruction of affected vertebra) and a posterior exposure (instrumentation of the spine) are quite invasive for these patients, while a posterior-only surgical approach requires small implants for anterior spinal column reconstruction. Intervertebral expandable titanium cages, although effective for this reconstruction, are expensive, and can represent the dominant cost for the reconstructive spinal procedure. In addition, they are often too large to insert safely from the posterior surgical approach. Thus, a critical need exists to provide these frail patients with a lower surgical burden while at the same time improving their quality of life. This research proposal aims to address a critical issue involved in the care of patients with metastatic spine defects. The goals of this proposal are to develop a novel expandable biomaterial system that can be delivered via a posterior-only surgical approach, would provide rigidity and stability to the spine, and would be much more cost effective than current expandable metal cages