磷酸钙骨水泥强化椎弓根螺钉固定的生物力学特性(英文)  

Biomechanical characteristics of calcium phosphate cement in the reinforcement of vertebral pedicle screw fixation

作　　者：黎逢峰[1] 张庆宏[1] 黄野[1] 王云华[1] 

机构地区：[1]南京医科大学第二附属医院骨科,江苏省南京市210011

出　　处：《中国临床康复》2006年第25期187-190,共4页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:聚甲基丙烯酸甲酯能改善椎弓根螺钉和周围骨质间界面的情况、显著提高螺钉固定强度,但它在术中和术后伴有聚合热损伤效应、毒性和不可吸收等缺点。磷酸钙骨水泥具有生物相容性和生物安全性好、可降解、不产生聚合热等优点,是一种较理想的聚甲基丙烯酸甲酯替代材料。目的:从生物力学方面评价磷酸钙骨水泥对椎弓根螺钉固定的强化作用。设计:随机对照,重复观察测量。单位:南京医科大学第二附属医院骨科。材料:实验于2002-08/2003-02在华中科技大学同济医学院完成。①由同济医科大学解剖教研室提供两具新鲜男性尸体椎骨,一具52岁,一具50岁。各取10个椎骨(T8～12,L1～5)分别构成52岁组和50岁组。摄X线片排除先天性畸形、骨折和肿瘤等病变。两组椎骨均为Ⅰ级骨质疏松,符合实验要求。②磷酸钙骨水泥固相主要成分是磷酸四钙和磷酸三钙超细粉末,液相主要成分是枸橼酸盐溶液,使用时按1g固相:1mL液相的比例进行配制,初步凝固时间15min,最终凝固时间12h,最大压缩强度介于45～57MPa。③椎弓根螺钉自制,螺钉直径5mm,螺纹段长34mm,螺距2mm,螺纹深0.8mm。方法:①磷酸钙骨水泥最终凝固时强化椎弓根螺钉固定的生物力学测试:取50岁组椎骨作为测试对象。对照侧:钉道直接置入椎弓根螺钉;强化侧:填入磷酸钙骨水泥再置入椎弓根螺钉。置钉后的椎骨在37℃恒温箱里放置12h,然后测定椎弓根螺钉的最大轴向拔出力。②磷酸钙骨水泥初步凝固时强化椎弓根螺钉固定的生物力学测试:取52岁组椎骨作为测试对象。用同样方法在椎弓根对照侧直接置入椎弓根螺钉,强化侧填入骨水泥后再置入椎弓根螺钉,37℃恒温箱里放置15min,测定椎弓根螺钉初步凝固时的最大轴向拔出力。③磷酸钙骨水泥强化松动椎弓根螺钉固定的生物力学测试:取测试后的50岁组椎骨,用磷酸BACKGROUND： Polymethylmethacrylate （PMMA） can ameliorate the condition between vertebral pedicle screws and peripheral bone-matrix interfaces and notably enhance the strength of screw fixation. However, there are several disadvantages during and after operation such as polymerized thermal damaging effect, toxicity and unabsorbable etc. Calcium phosphate cement （CPC） is biocompatible and biodegradable with good biosafty and produce no heat of polymerization, which is a perfect substitute for PMMA. OBJECTIVE： To evaluate the reinforcing effect of CPC on vertebral pedicle screw fixation at biomechanical aspect. DESIGN： Randomized control and repetitive observed measurement. SETTING： Department of Orthopaedics, Second Affiliated Hospital of Nanjing Medical University. MATERIALS： The experiment was conducted in Tongji Medical College of Huazhong University of Science and Technology from August of 2002 to February 2003. （1）Two fresh spines from male bodies respectively aged of 52 and 50 years were provided by the Anatomic Department of Tongji Medical College. Ten vertebrae in each spine were obtained （T8-12, L1-5） and taken as 52-year group and 50-year group, Radiographs of these vertebrae were taken to exclude congenital abnormality, fracture, tumor or other pathological changes. Vertebrae in both groups were osteoporoscs of grade 1 and in accordance with experimental requirement.（2）Main components of solid phase of CPC were micropowder of tricalcium phosphate and tetraealeium phosphate （ITCP） and its main ingredients of liquid phase was citrate solution, which was prepared with solid phase in the ratio of lg vs 1 mL. Primarily setting-time was 15 minutes and the final setting-time was 12 hours with the maximum compressive strength between 45 MPa and 57 MPa. （3）Diameter of self-made pedicle screws was 5 nun; Length of screw thread segment was 34 mm; Pitch was 2 nun; Depth of screw thread was 0.8 mm. METHODS＂ （DBiomechanical test of pedicle screw fixation at final solid time o

关 键 词：磷酸钙类 生物相容性材料 骨粘合剂/治疗应用 骨质疏松/病理生理学 骨螺丝 

分 类 号：R318.01[医药卫生—生物医学工程]