مجله جراحی استخوان و مفاصل ایران

مقایسه کاربرد کیج‌های بین مهره‌ای تیتانیومی و پلیمری در عمل‌های فیوژن ستون فقرات: مروری بر مطالعات کلینیکی

نوع مقاله : مقاله پژوهشی

نویسندگان

سید محمد معین فاطمی 1
محمد نیکخو 2
مصطفی رستمی 3
چی شیو چنگ 4

1 دانشجوی دکترای تخصصی گروه مهندسی پزشکی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران

2 استادیار، گروه مهندسی پزشکی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران

3 دانشیار، دانشکده مهندسی پزشکی، دانشگاه صنعتی امیرکبیر، تهران، ایران

4 دانشیار، مرکز تحقیقات استخوان و مفاصل، بیمارستان آموزشی درمانی چنگ گانگ، لینکو، تایوان

https://doi.org/10.22034/ijos.2021.130299
چکیده
پیش زمینه: عمل جراحی فیوژن ستون فقرات در سال‌های اخیر به‌عنوان یکی از رایج‌ترین درمان‌ها برای آسیب‌های ستون فقرات مطرح است. همچنین کیج‌های بین مهره‌ای که جایگزینی برای دیسک‌های بین مهره‌ای آسیب‌دیده در این عمل‌های جراحی هستند طی دهه‌های گذشته، دست‌خوش تغییرات گسترده‌ای در زمینه طراحی و مواد اولیه شده‌اند. این تغییرات از ساخت کیج‌های ساده تیتانیومی با روش‌های رایج ساخت و تولید تا کیج‌های شخصی‌سازی‌شده متخلخل تیتانیومی توسط تکنولوژی ساخت افزودنی یا کیج‌های پلیمری پوشش‌دهی‌شده با تیتانیوم، کاملاً قابل‌مشاهده است.
مواد و روش ها: در بین تمامی مواد اولیه که در ساخت کیج‌های بین مهره‌ای کاربرد دارد پلیمر پلی اتراتر کتون (PEEK) و فلز تیتانیوم، از رایج‌ترین مواد هستند. هرکدام از این دو ماده، مزایا و معایب خود را دارند و در مطالعات زیادی به مقایسه آنها پرداخته شده است. دو معیار نرخ فرونشست و نرخ جوش‌خوردگی معیارهای اصلی در مطالعات بالینی صورت‌گرفته برای مقایسه این دو نوع کیج می‌باشند.
یافته‌ها: در این بررسی سعی شده است با مرور جامع مطالعات کلینیکی چاپ شده در زمینه مقایسه دو کیج تیتانیومی و PEEK به جمع‌بندی و مقایسه جامع این دو نوع کیج پرداخته شود.
 نتیجه گیری: پس از بررسی مطالعات انجام شده مشخص گردید در رابطه با نرخ فرونشست، هر دو گروه نتایج نسبتاً مشابهی ارائه داده‌اند و برتری خاصی در هیچ‌کدام از کیج‌های تیتانیومی یا PEEK وجود ندارند اما کیج تیتانیومی در نرخ جوش‌خوردگی، نتایج بهتری ارائه کردند و در کلینیک درصد موفقیت بالاتری نسبت به کیج PEEK گزارش شده است.

کلیدواژه‌ها

ستون فقرات
تیتانیوم
فیوژن ستون فقرات
تعویض کامل دیسک
پلیمر ها

موضوعات

عنوان مقاله English

Comparison between Titanium and Polymer Interbody Cages in Spinal Fusion Surgery: A Review of Clinical Studies

نویسندگان English

Seyyed Mohammad Moein Fatemi 1
Mohammad Nikkhoo 2
Mostafa Rostami 3
Chih-Hsiu Cheng 4
1 PhD Student, Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
2 Assistant Professor, Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran.
3 Associate Professor, Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
4 Associate Professor, Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
چکیده English

In recent years, spinal fusion surgery has become one of the most common treatments for spinal cord injuries, while the interbody cages, which replace the damaged interbody discs in the surgeries, have undergone extensive changes in design and material. These changes are quite visible, ranging from plain titanium cages made using the conventional manufacturing methods to customized porous titanium cages, which are made using additive manufacturing technology, or titanium-coated polymer cages. Among all the materials used in manufacturing the interbody cages, PolyEther Ether Ketone (PEEK) and titanium are the most common ones. Each of these two has its own advantages and disadvantages. Several studies have compared these two materials, mostly based on the two characteristics of subsidence and fusion rates. The present study performed a comprehensive review of the published clinical studies comparing the titanium and PEEK cages in order to make a comprehensive evaluation of these two. According to the reviewed studies, both materials had relatively similar results in subsidence rate, with no significant difference. However, it was shown that the titanium cages had a better fusion rate and subsequently were more likely to be successful in the clinical settings than the PEEK cages.

کلیدواژه‌ها English

Spine
Titanium
Spinal fusion
Total Disc Replacement
Polymers
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