椎体成形术中骨水泥渗漏对椎间盘生化改变的影响  

The effect of cement leakage occurred during vertebroplasty on intradiscal biochemistry variations

作　　者：赵辉[1] 倪才方[2] 黄健[1] 陈珑[2] 唐天驷[3] 杨惠林[3] 

机构地区：[1]南通大学附属医院介入放射科,226001 [2]苏州大学附属第一医院介入放射科 [3]苏州大学附属第一医院骨科

出　　处：《介入放射学杂志》2011年第8期641-644,共4页Journal of Interventional Radiology

基　　金：江苏省"135"工程重点人才基金(RC2003097)

摘　　要：目的探讨骨水泥椎间盘渗漏后椎间盘糖胺多糖(GAG)含量变化,以及GAG含量的改变与骨水泥种类、骨水泥渗漏量和渗漏后的时间是否有关。方法选用16只成年家犬按模型制作后观察时间点随机分为12周及24周两组。每只犬L1/2-L5/6共5个椎间盘为实验对象,随机分成A(对照组)、B1(PMMA 0.1 ml)、B2(PMMA 0.3 ml)、C1(CPC 0.1 ml)、C2(CPC 0.3 ml)5组。对12及24周观察时间内骨水泥组及对照组行方差分析,用析因设计的方差分析比较两种骨水泥之间、两种剂量之间的GAG含量有无差别。结果两两比较12周及24周骨水泥组的椎间盘GAG含量与对照组差别均有统计学意义(P<0.05)。在骨水泥组内行析因设计的方差分析,术后两观察时间之间、两种骨水泥之间、两种剂量之间椎间盘GAG含量差别均有统计学意义。结论骨水泥椎间盘渗漏会导致椎间盘的GAG含量下降,蛋白多糖合成下降。椎间盘的GAG含量改变与骨水泥渗漏入椎间盘量有关,与骨水泥渗漏入椎间盘后时间有关,与骨水泥类型有关。Objective To investigate the effect of intradiscal cement leakage occurred during vertebroplasty on the changes of glycosaminoglycan contents in the disc, and to analyze the relationship of disc biochemistry to the time interval after the procedure, to the kinds of bone cement and to the amount of cement leakage. Methods Sixteen adult dogs （15 - 17 kg） were randomly divided into 12-week group and 24-week group. Five lumbar intervertebral discs （LI/2 - L5/6） in each dog were classified into 5 groups： one disc was used as control group and the remaining four discs were used as bone cement groups （PMMA and CPC）. Each of cement groups was classified into 2 dose subgroups （0.1 ml and 0.3 ml）. The lumbar intervertebral discs of the dog were punctured with an 18-gauge needle, and bone cement was injected into them in cement groups. Control discs were only punctured and injected with nothing. The contents of glycosaminoglycan in the annulus fibrosus and nucleus pulposus of discs were determined and were analyzed for their biochemical properties. ANOVA and Scheffe-test were used to make the statistical analyses. Results In control group, the contents of glycosaminoglycan in annulus fibrosus and nucleus pulposus were not significantly different between 12-week group and 24-week group （P 〈 0.05）. In 12-week group, significant difference in the contents of glycosaminoglycan existed between the control group and the bone cement groups when analysis of variance was used （P 〈 0.05）, and the same result was observed in 24-week group （P 〈 0.05）. By using Scheffe test, no matter in the 12-week group or in the 24-week group, the contents of glycosaminoglycan in annulus fibrosus and nucleus pulposus of cement groups were significantly different from those of the control group （P 〈 0.05）. Significant difference existed between the groups with different time interval, using different doses and belonging to different category of bone cement in bone cement groups when univariate analysis of vari

关 键 词：椎间盘退变 蛋白多糖 糖胺多糖 

分 类 号：R687.3[医药卫生—骨科学]