经皮椎体成形术治疗骨质疏松椎体压缩骨折体外力学实验研究  

An ex Vivo Biomechanical Evaluation of Vertebroplasty used in the Treatment of Osteoporotic Compression Fracture

作　　者：唐迎九[1] 杨惠林[1] 章洪喜[2] 王海[3] 陈文忠[4] 苏虹[5] 

机构地区：[1]苏州大学附属第一医院骨科,江苏苏州215006 [2]江苏大学附属人民医院骨科,江苏镇江212002 [3]江苏大学附属人民医院CT室,江苏镇江212002 [4]江苏大学附属人民医院放射科,江苏镇江212002 [5]江苏大学理学院,江苏镇江212013

出　　处：《江苏大学学报（医学版）》2004年第30期199-201,204,共4页Journal of Jiangsu University：Medicine Edition

摘　　要：目的 :探讨经皮椎体成形术对骨质疏松压缩骨折椎体力学性能的影响。方法 :5具老年女性胸腰段脊柱标本 (T11～L2 ) ,X线摄片无明显病理异常 ,用双能X线吸收骨密度仪 (DEXA)测定椎体骨密度 (BMD) ,证实为骨质疏松标本。将标本游离成单个椎体 ,每具标本选择 2个椎体共 10个椎体 ,用材料试验机轴向加载 ,压缩椎体高度 2 5 % ,制造椎体压缩骨折 ,获得椎体原始最大载荷及刚度数据。对骨折椎体进行椎体成形术注入聚甲基丙烯酸甲酯 (骨水泥 ) ,观察骨水泥外渗漏情况。测试骨水泥强化治疗后椎体最大载荷及刚度。结果 :椎体骨水泥平均注入 4 84ml,有 4个椎体出现椎体外骨水泥渗漏。椎体原始最大载荷及刚度分别为 (16 0 6± 2 4 9 5 )N和 (112 2 3± 183 4 )N/mm ;压缩骨折经皮椎体成形术 (PVP)治疗后椎体最大载荷及刚度分别为 (374 0± 12 15 6 )N和 (96 0 4± 2 33 3)N/mm。治疗前后比较经皮椎体成形术明显增加了骨折椎体最大载荷 (P <0 0 5 )和恢复了刚度 (P >0 0 5 )。结论 :骨质疏松压缩骨折椎体内注射骨水泥 (PMMA) ,可显著增加骨折椎体的抗压强度和恢复刚度 ,临床应用经皮椎体成形术治疗骨质疏松椎体压缩骨折可达到强化骨折椎体的目的。Objective: To examine whether percutaneous vertebroplasty is effective in biomechanical strengthening osteoporotic vertebral bodies subjected to compression fractures. Methods: Ten osteoporotic vertebral bodies were harvested from five female embalmed cadavers,screened for BMD using DEXA and separated into individual vertebral bodies. All vertebral bodies were compressed in a materials testing machine to determine their initial strength and stiffness. They were then repaired using a transpedicular injection of PMMA (bipedicular). They were recompressed to determine their augmented strength and stiffness. Results: The initial strength and stiffness of osteoprosis vertebral bodies were (1 606±249 5)N and ( 1 122 3 ±183 4)N/mm; the augmented strength and stiffness were (3 740±1 215 6)N and (960 4±233 3)N/mm. The augmented strength was greater than the initial strength( P <0 05)and there was no significant difference between the initial stiffness and augmented stiffness( P >0 05). Conclusion: Injection of PMMA using percutaneous vertebroplasty technique appeared to have strengthened osteoporotic vertebral compression fractures.

关 键 词：经皮椎体成形术 骨水泥 骨质疏松椎体压缩骨折 生物力学 

分 类 号：R322-33[医药卫生—人体解剖和组织胚胎学]