摘要
目的探讨单侧和双侧球囊扩张注射生物活性锶羟基磷灰石骨水泥（SrHAC）行椎体后凸成形术对骨折椎体模型的高度和生物力学性能的修复能力。方法从2具新鲜冰冻人脊柱标本中分离14个椎体（T8～L5），随机分为单侧组（单侧球囊扩张注射SrHAC）和双侧组（双侧球囊扩张注射SrHAC），每组7个椎体。测量各椎体的骨密度、原始高度后，对各椎体标本施加轴向压力负载，测出各椎体的原始强度和原始刚度，并建立椎体压缩骨折模型。测量椎体骨折后的刚度。在c型臂x线机下手术，术中控制球囊扩张的体积均为3．00mL，术后测量各椎体的高度、强度和刚度。用单因素方差分析比较两组椎体的骨密度、原始刚度和原始强度。用配对t检验比较两组椎体的高度和生物力学性能在手术前、后的改变，其中椎体中线两侧高度差在手术前、后的改变用单因素方差分析。结果两组椎体的骨密度、原始强度和刚度之间差异无统计学意义（P〈0．05）。骨折后，椎体的前缘、中线和后缘高度均减少，刚度较原始刚度降低。单侧组平均注入3．07mLSrHAC，双侧组平均注入5．82mLSrHAC。术后椎体各部位的高度均有所增加，但未能恢复到原始高度水平。术后两组椎体中线两侧的高度及两组椎体强化后的强度差异均无统计学意义（P〉0．05）。两组椎体强化后的刚度均有一定程度的修复，双侧组较单侧组刚度修复效果好。结论单侧或双侧注射SrHAC行球囊扩张椎体后凸成形术均能修复骨折椎体模型的高度和生物力学性能。
Objective To evaluate unipedicular and bipedicular balloon kyphoplasty with bioactive ning hydroxyapatite cement （SrHAC） in restoration of vertebral height and biomechanical properties in simulated compressive fracture models. Methods Fourteen vertebrae were collected from 2 fresh frozen human spines. The bone mineral density （BMD） and initial height of each vertebra were measured and the initial strength and stiffness under axial load on an MTS machine before compressive fracture models were created. Next the height and stiffness of the fractured vertebrae were measured before the models were randomized into 2 groups. In the unipedicular group, unipedicular balloon kyphoplasty with SrHAC was done; in the bipedicular group, bipedicular balloon kyphoplasty with SrHAC was done. The procedures were performed under C-ann guidance. After the procedure, the vertebral height and biomechanical properties were measured. The measurements of BMD, initial strength and initial stiffness were compared with l-Way Analysis of Variance （ANOVA） between groups. The differences in height and biomechanical restoration before and after operation were compared with Pair-T test but the differences in midline height were analyzed with ANOVA. Results There were no significant differences in BMD, initial strength and initial stiffness of vertebrae between the 2 groups. The mean cement volume injected was 3.07 mL in the unipedicular group and 5.82 mL in the bipedicular groups. After cement augmentation, the strength of the augmented vertebrae was significantly greater than the initial strength in both groups, but there was no significant deference between the 2 groups. The stiffness of the augmented vertebrae was also significantly greater than that of the fractured vertebrae in both groups, but it was not restored to the initial level. There was significant difference between unipedicular and bipedicular groups in restored stiffness. The height restoration was seen in both groups. Conclusion balloon kyphoplasty with bioactive strontium-containing hydroxyapatite cement can restore vertebral height and biomechanical properties in simulated compressive fracture models.
出处
《中华创伤骨科杂志》
CAS
CSCD
2007年第4期362-366,共5页
Chinese Journal of Orthopaedic Trauma
基金
广东省科技厅重点攻关项目（2004833101001）
广州市科技委员会基金项目（200423-E0521）
