生物型cage椎间骨整合:界面的组织细胞学特性及骨整合愈合机制.

BACKGROUND: Biological cage has been widely used in the fields of spinal orthopedics, nanometer materials and bionic biomedicine as the substitutes of new bone repair materials due to its high mechanical properties and biocompatibility. However, its effects remain controversial.OBJECTIVE: To summarize and discuss the current design conception, biomechanical characteristics,degradation properties, basic and clinical research of biological cage, so as to provide basis for clinical application of biological cage.METHODS: CNKI, WanFang and PubMed databases were retrieved with the key words "biological cage,biocompatibility, degradation properties, mechanical properties" in Chinese and English, respectively. The preparation, mechanics, degradation characteristics and experiments of biological cage were summarized.RESULTS AND CONCLUSION: One hundred and thirty-two articles were retrieved and 48 eligible articles were included according to inclusion and exclusion criteria. The combination of biphasic or mutiphase materials has become the mainstream of cage design, and tissue engineering and surface modification have effectively promoted the intervertebral fusion. At present, the main drawbacks are the mechanical instability and aseptic inflammation caused by its own degradability which still needs to be further explored. The biological cage based on polylactic acid and β-tricalcium phosphate can complement each other. This copolymer can simultaneously meet the mechanical properties and biocompatibility during the fusion. What needs attention is that the curvature of cage, place position and matching degree with the upper and lower endplates are important factors affecting the intervertebral bone integration. However, the concrete mechanism of osteointegration remains unclear. The gene expression of the cytokines, the signaling pathway, the effect of the cage on the bone repairing cell proliferation and aseptic cage loosening need further exploration. [ABSTRACT FROM AUTHOR]