单侧PKP骨水泥注射过中线分布对压缩性骨折椎体两侧刚度的影响  

Effects of cross-midline cement distribution on the stiffness of varied sites in compressive fractured vertebrae after unipedicular PKP:a biomechanical study

作　　者：陈柏龄[1] 谢登辉[1,2] 黎艺强[1] 庄新明[1] 杨晓曦[1] 于滨生[1] 郑召民[1] 

机构地区：[1]中山大学附属第一医院脊柱外科,广州市510080 [2]广州市儿童医院骨科,广州市510120

出　　处：《中国脊柱脊髓杂志》2011年第2期118-121,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:评价单侧椎体后凸成形术(PKP)中骨水泥注射超越椎体中线与否对椎体轴向及两侧刚度的影响。方法:3具防腐成人胸腰椎椎体标本(T4～L1)用于实验。通过MTS平台给椎体施加轴向压力,制作压缩性椎体骨折模型,同时进行球囊辅助下经单侧椎弓根穿刺椎体后凸成形术,根据骨水泥是否过椎体中线分为两组,骨水泥注射不过椎体中线(A组,n=9);骨水泥注射过椎体中线(B组,n=8),骨水泥注射量为椎体体积的10%。24h后放置在MTS-858材料实验平台上,给标本分别施加0～300N轴向和侧方压力载荷,记录并比较骨水泥注射术后,两组椎体轴向及两侧的刚度差异。结果:轴向压缩载荷下,A组与B组间轴向压缩刚度无显著差异(P>0.05);在椎体侧方压缩载荷下,尽管A组椎体骨水泥穿刺侧的刚度与B组间差异无显著性(P>0.05);但在非穿刺侧刚度上,B组显著高于A组,差异有显著性(P<0.05)。结论:行单侧PKP时,若骨水泥填充不过椎体中线时,则非穿刺侧刚度明显低于穿刺侧,而骨水泥填充过中线时,则两侧椎体刚度可同时得到显著强化。Objective：To evaluate the effects of cross-midline cement injection on axial and bilateral vertebral stiffness of varied sites in compressive fractured vertebrae after unipedicular PKP.Method：Vertebral bodies harvested from 3 cadaver spines（T4-L1） were experimentally induced into compressive vertebral fractures models by MTS.Subsequently the specimens were stabilized using transpedicular balloon-assisted PKP（group A,n=9,unipedicular hemivertebral,non cross-midline cement injection,group B,n=8,unipedicular cross-midline cement injection） and the volume of cement filling were 10% of the vertebral body.Then the stablized vertebral bodies were subjected to axial and sided compression loads（0-300N,cycled） by MTS 24 hours later.After that,the stiffness was measured and compared between the two groups.Result：Under axial loading,the stiffness between group A and B showed no significant difference（P〉0.05）.While under sided compression loading,despite of no difference of stiffness in penetration side between group A and B（P〉0.05）,the stiffness in non-penetration side in group B increased more than that in group A（P〈0.05）.Conclusion：When performing unipedicular balloon-assisted kyphoplasty,cross-midline cement distribution or not will impact the side-related stiffness significantly.

关 键 词：生物力学 经皮椎体后凸成形术 骨水泥 侧方压缩 

分 类 号：R687.3[医药卫生—骨科学]