应用新型Vessel-X骨材料填充器注射聚甲基丙烯酸甲酯的实验研究  

Experimental study of vertebral augmentation with a novel Vessel-X bone void filling container system by PMMA injection

作　　者：郑召民[1] 邝冠明[1] 董智勇[1] 吕维加[2] 李朝阳[2] 吕游[1] 陈辉[1] 刘辉[1] 张奎渤[1] 李佛保[1] 

机构地区：[1]中山大学附属第一医院脊柱外科,广州,510080 [2]香港大学矫形与创伤外科学系

出　　处：《中华骨科杂志》2008年第8期-,共6页Chinese Journal of Orthopaedics

摘　　要：目的 探讨新型Vessel-X骨材料填充器对注射聚甲基丙烯酸甲酯(PMMA)在椎体内分布影响及对椎体力学性能的修复效果.方法 将新鲜冰冻人椎体标本14个随机分单侧穿刺和双侧穿刺组.每组7椎.测量各标本的骨密度、前后缘和中线高度以及原始刚度和强度后,建立压缩骨折模型.测量骨折后标本的高度和剐度.应用Vessel-X骨材料填充器注射PMMA后再次测量椎体的高度、强度和刚度.观察填充器在椎体内的膨胀情况及PMMA在椎体内的分布情况.结果 两组椎体术后的强度均较原始大,但术后强度比较差异无统计学意义.两组椎体术后刚度较骨折后水平均有恢复,双侧组较单侧组刚度恢复效果好.术后椎体各部位的高度均增加,但未恢复到原始高度水平.术后两组椎体中线两侧的高度差比较差异无统计学意义.轴位透视下见骨水泥在椎体内呈椭圆形或长椭圆形分布,与填充器在体外膨胀后的形状相似.横断标本后,见填充器能在椎体内良好膨胀,包裹绝大部分PMMA,仅少量PMMA渗漏到网层外,但均局限在网层周围.结论 Vessel-X骨材料填充器在椎体标本内能包裹绝大部分PMMA,可防止骨水泥渗漏,且能恢复骨折椎体的力学性能和高度.Objective To find out the effect of Vessel-X bone void filling container on polymethyl methacrylate(PMMA)distilbution controlling within the vertebral body and the restoration of biomechanical properties after augmentation.Metbods 14 fresh frozen human vertebrae specimens were randomly divided into two groups according to unipedicular and bipedicular injection.After measuring the bone mineral density (BMD) and vertebral height,each vertebrae were applied to axle lead by MTS machine to test the initial strength and stiffness,and subsequently created simultaneous compressive fracture models.After the augmentation procedure,the biomechanical properties and the vertebral height were similarly measured as preoperation.The expansion of Vessel-X bone void filling container and the PMMA distribution within the vertebral body were morphologically observed by crossing the specimen in sagittal midline,and also integraded with radiography results.Results The strength of specimen was significantly increased after augmentation procedure but without significant difference between groups.The stiffness was also significantly restored compared with that of fractured level and the bipedicular group had better restoration results than the unipedicular groups.The height restoration wag found in both groups but no difference between two sides of midline pre-and post-operation.In axial view of radiography.the distribution of cement in the vertebral body Wag just like the configuration of ellipse which wag similar to the shape Vessel-X bone void falling container expanded in vitro.After crossed.the Vessel-X bone void filling container expanded well in the vertebral body and the container enwrapped most of the PMMA iniected.No PMMA Wag found out of the vertebral body.Conclusion This novel Vessel-X bone void filling container system can enwrap most of the PMMA injected into the vertebral body,reduce cement leakage,and restore biomechanical properties and height of simultaneous vertebral compressive fracture.

关 键 词：脊柱骨折 骨质疏松 甲基丙烯酸甲酯类 生物力学 

分 类 号：R686[医药卫生—骨科学]