摘要
目的观察防腐椎体标本应用高、低黏度骨水泥行椎体成形术后生物力学和渗漏率的差异并探讨其原因。方法选取6具女性、年龄（65±2）岁防腐尸体标本，游离T10～14椎体，共获得42个椎体标本，应用x线排除结核、肿瘤等疾病，并筛选m骨密度相近的36个椎体标本，余椎体做预实验。各标本经生物力学试验机制成压缩骨折模型，随机分为A、B两组（n=18），A组注入低黏度骨水泥，B组注入高黏度骨水泥。随后将各椎体进行生物力学实验，同时cT扫描统计各组椎体骨水泥渗漏例数并计算其渗漏率，评估各椎体骨水泥分布。结果两组椎体标本注入骨水泥后最大垂直载荷和刚度分别为：A组：（3761．03±693．55）N、（472．27±52．05）N／mm；B组：（3965．31±999．90）N、（1039．38±345．11）N／mm。术后最大垂直载荷组问差异无统计学意义（Z=-0．127，P=0．450）。术后刚度组间差异有统计学意义（Z=-5．125，P=0．000）。A组共有8个椎体发生渗漏，渗漏率为44．44％；B组共有2个椎体发生渗漏，渗漏率为11．11％，组间比较差异有统计学意义（P=0．026）。结论高黏度骨水泥较低黏度骨水泥可显著提高椎体成形术后椎体的刚度，但是对最大垂直载荷影响不大，且高黏度骨水泥可明显降低其渗漏率。
Objective To explore the differences of biomechanics and leakage rate in high and low viscosity bone cement after vertebroplasty and to analyze the reasons. Methods Forty - two vertebral bodies were harvested from 6 embalmed cadavers. All specimens were subjected to the X - ray examination to exclude tuberculosis, tumor and other diseases. Thirty - six vertebral specimens with similar bone densi- ty were selected. All specimens were selected to make into compression fracture model by the biomechani- eal machine for further test. The model of compression fracture was divided into two groups randomly： A and B （n = 18 each）. The group A was injected with low viscosity bone cement and the group B with high viscosity. The biomechanical testing was carried out before the fracture and after cement injection. The cement leakage rate and distribution of cement were assessed with the reference of postoperative CT scan. Results In group A and group B, the maximum vertical load and stiffness after cement injection were （3761.03±693.55） N, （3965.31±999.90） N; （472.27± 52.05） N/ram, （1 039.38 ±345.11 ） N/mm, respectively. After vertebroplasty, the maximum vertical load showed no significant difference between 2 groups. （ Z = - 0. 127, P = 0. 450） , and the stiffness was statistically significant （ Z = -5. 125, P =0. 000）. The leakage rate was significantly higher in group A （44. 44% ） than in group B （ 11.11% ） （ P = 0. 026 ）. Conclusion High viscosity bone cement can increase the stiffness of vertebral body and have little effect on the maximum vertical load in comparison to the low viscosity. Furthermore, the high viscosity significantly decreases the rate of bone cement leakage.
作者
王坤龙
齐向北
王鹏飞
李旭
高翔
赵云
Wang Kunlong;Qi Xiangbei;Wang Pengfei;Li Xu;Gao Xiang;Zhao Yun(Department of Orthopaedics, the Third Hospital, Hebei Medical University, Hebei Key Laboratory of Biome- chanics of Orthopedics, Shijiazhuang 050051, China)
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2018年第6期1126-1128,共3页
Chinese Journal of Experimental Surgery
基金
河北省自然科学基金（H2012206068）
政府资助临床医学优秀人才培养项目基金
关键词
椎体成形术
高
低黏度骨水泥
生物力学
渗漏率
Vertebroplasty
High
low viscosity bone cement
Biomechanics
Bone cementleakage rate
