背景:机械生物学可以通过提供对骨愈合和融合所需的机械环境的见解来帮助优化脊柱融合。这包括了解最佳加载条件,植入材料的机械性能,以及机械刺激对参与骨形成的细胞的影响。本文回顾了脊柱融合器的表面技术和植入物修饰在增强脊柱融合方面的证据。
方法:使用的数据库包括Embase,MEDLINE,Springer,科克伦图书馆使用特定的关键字和搜索字段识别相关文章。只有系统的审查,荟萃分析,评论文章,包括英文的原始研究文章。两名研究人员独立进行搜索和选择过程。文章提供了搜索策略和研究选择方法的流程图。
结果:研究表明,表面修饰可以通过促进细胞粘附来显着增强骨整合和椎体间融合,扩散,分化,和矿化。各种表面改性技术,如涂层,蚀刻,纳米形貌,和功能化实现了这一点。同样,种植体材料改性可以提高种植体的稳定性,生物相容性,和生物活性,导致更好的融合结果。机械生物学通过影响细胞对机械线索的反应和促进骨形成在这一过程中起着至关重要的作用。
结论:综述的研究表明,表面技术和植入材料改性是提高脊柱融合成功率的有希望的方法。机械生物学通过影响细胞对机械信号的反应并促进骨骼生长而在此过程中至关重要。
BACKGROUND: Mechanobiology can help optimize spinal fusion by providing insights into the mechanical environment required for bone healing and fusion. This includes understanding the optimal loading conditions, the mechanical properties of implanted materials, and the effects of mechanical stimuli on the cells involved in bone formation. The present article reviews the evidence for surface technologies and implant modification of spinal
cages in enhancing spinal fusion.
METHODS: Databases used included Embase, MEDLINE, Springer, and Cochrane Library. Relevant articles were identified using specific keywords and search fields. Only systematic reviews, meta-analyses, review articles, and original research articles in English were included. Two researchers independently performed the search and selection process. A flowchart of the search strategy and study selection method is provided in the article.
RESULTS: The studies indicate that surface modification can significantly enhance osseointegration and interbody fusion by promoting cellular adhesion, proliferation, differentiation, and mineralization. Various surface modification techniques such as coating, etching, nanotopography, and functionalization achieve this. Similarly, implant material modification can improve implant stability, biocompatibility, and bioactivity, leading to better fusion outcomes. Mechanobiology plays a vital role in this process by influencing the cellular response to mechanical cues and promoting bone formation.
CONCLUSIONS: The studies reviewed indicate that surface technologies and implant material modification are promising approaches for improving the success of spinal cage fusion. Mechanobiology is critical in this process by influencing the cellular response to mechanical signals and promoting bone growth.