Novel Polymeric Scaffolds for Less Invasive Reconstruction of Metastatic Spine Segments

用于转移性脊柱节段微创重建的新型聚合物支架

• 批准号: 9254889
• 负责人: Hugo Giambini
• 金额: $ 5.92万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-01-11 至 2019-01-10
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9254889
• 关键词: Address; Affect; Anatomy; Anterior; Biocompatible Materials; Biomechanics; Cadaver; Caliber; Caring; Charge; Defect; Deposition; Devices; Dimensions; Excision; Family; Fumarates; Goals; Home environment; Hydrogels; Implant; In Situ; Infiltration; Injectable; Intervertebral disc structure; Kinetics; Knowledge; Laboratories; Length; Length of Stay; Life; Malignant Neoplasms; Measures; Mechanics; Medical; Mesenchymal Stem Cells; Metals; Metastatic Neoplasm to the Bone; Methods; Neoplasm Metastasis; Nerve; Oligonucleotides; Operative Surgical Procedures; Outcome; Patient Care; Patients; Polymers; Preparation; Procedures; Process; Quality of life; Rehydrations; Research; Research Proposals; Site; Spinal; Spinal Fractures; Surface; Surgeon; Swelling; System; Techniques; Testing; Time; Titanium; Tube; United States; Vertebral column; Weight-Bearing state; Work; base; biomaterial compatibility; biomaterial development; bone; career; career development; cost; cost effective; crosslink; design; ethylene glycol; experience; fracture risk; improved; instrumentation; kinematics; mechanical properties; novel; novel strategies; operation; osteoblast differentiation; poly(propylene fumarate); prevent; reconstruction; scaffold; skeletal; skills; spine bone structure; standard of care; tumor; vertebra body

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

项目概要 确定癌症转移到骨性脊柱后，治疗临床医生有义务做出以下决定： 手术决定。如果脊柱被认为不稳定并且有骨折的风险，那么患者将接受重大手术 脊柱手术后，他们通常会花费大部分的余生来康复。椎体 转移有时通过受影响椎体和邻近椎间的椎体切除术来治疗 椎间盘，造成非包容性骨骼缺损，需要前柱脊柱重建和后柱脊柱重建 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（脊柱器械）对这些患者来说是相当具有侵入性的， 而仅后路手术方法则需要使用小型植入物来重建前路脊柱。 椎间可扩张钛融合器虽然对于这种重建有效，但价格昂贵，并且可以 代表重建脊柱手术的主要成本。此外，它们往往太大而无法 从后手术入路安全插入。因此，迫切需要为这些虚弱的患者提供 减轻手术负担，同时提高生活质量。本研究计划旨在 解决转移性脊柱缺陷患者护理中涉及的一个关键问题。本提案的目标 正在开发一种新型可扩张生物材料系统，可以通过后路手术输送 方法，将为脊柱提供刚性和稳定性，并且比目前的方法更具成本效益 可膨胀金属笼