记忆合金支架在椎体骨折中的实验研究  

Experimental Study of Memory Alloy Stent in the Treatment of Vertebral Compression Fracture

作　　者：杨益民[1] 张智[1] 李萌[1] 任志伟[1] 马巍[1] 

机构地区：[1]西安交通大学第一附属医院骨科,西安710061

出　　处：《中国微创外科杂志》2014年第8期751-754,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：陕西省科学技术研究发展计划项目(2011K12-04-01)

摘　　要：目的探讨自主研制的镍-钛记忆合金椎体支架(memory alloy vertebral stent)治疗椎体压缩性骨折的可行性。方法将成人尸体胸腰椎脊柱标本制成压缩性骨折模型,分成球囊扩张后植入镍-钛记忆合金椎体支架组(PKP+支架组)、直接植入镍-钛记忆合金椎体支架组(PVP+支架组)及球囊扩张后骨水泥填充组(PKP+PMMA组)。手术前后测量椎体高度,比较3组压缩椎体复位程度。结果 3组术后椎体高度均明显高于术前,PKP+支架组、PVP+支架组和PKP+PMMA组的椎体高度分别从术前的(1.59±0.08)cm、(1.68±0.08)cm和(1.66±0.11)cm复位至术后的(2.00±0.09)cm、(1.87±0.04)cm和(1.99±0.09)cm(t=-9.781、-7.952、-18.213,P=0.000、0.001、0.000)。各组手术前后椎体高度差比较,PKP+支架组[(0.39±0.09)cm]和PKP+PMMA组[(0.33±0.04)cm]明显大于PVP+支架组[(0.19±0.06)cm](P=0.000,0.003),而PKP+支架组与PKP+PMMA组差异无显著性(P=0.172)。结论镍-钛记忆合金椎体支架能有效地支撑、复位压缩的椎体终板,是对无神经症状的椎体骨折治疗方式的一种新的探索。Objective To evaluate the feasibility of a self-designed Ni-Ti memory alloy vertebral stent in the treatment of vertebral compression fractures. Methods Experimental thoracic-lumbar fracture models made from adult cadaver vertebral specimens were randomly assigned into 3 groups for testing： percutaneous balloon kyphoplasty with implanted Ni-Ti memory alloy vertebral stent （ PKP ＋ stent group） , percutaneous vertebroplasty with implanted Ni-Ti memory alloy vertebral stent （ PVP ＋ stent group） , and pereutaneous balloon kyphoplasty with implanted polymethyl methacrylate cement （PKP ＋ PMMA group）. The vertebral height was measured before and after the three kinds of operations, respectively, to compare the restoration of compression fractures. Results In all the three groups, the vertebral height of postoperation was significantly higher than the preoperation. The vertebral height of the PKP ＋ stent group, PVP ＋ stent group, and PKP ＋ PMMA group was increased from （ 1.59 ± 0.08） cm, （ 1.68 ± 0.08） cm, and （1.66 ±0.11） em before the operation to （2.00 ±0.09） cm, （1.87 ±0.04） cm, and （1.99 ±0.09） cm after the operation, respectively （ t = - 9. 781, - 7. 952, and - 18. 213, P = 0. 000, 0. 001, and 0. 000）. The subtract result before and after surgery on vertebral height was calculated. There were significant differences between the PKP ＋ stent group and PVP ＋ stent group [（0.39 ±0.09） em vs. （0.19 ±0.06） cm, P=0.0001, and between the PKP ＋PMMA group and PVP ＋stcnt group [（0.33 ± 0.04） cm vs. （0, 19 ± 0.06） cm, P = 0. 003 ]. However, there was no statistical difference between the PKP ＋ stent group and PKP ＋ PMMA group （P = 0. 172）. Conclusion The Ni-Ti memory alloy vertebral stent can effectively support and restore the collgpse of the vertebral endplate, and it is an effective treatment for vertebral compression fractures without nerval symptoms.

关 键 词：镍-钛记忆合金 椎体压缩性骨折 椎体后凸成形术 

分 类 号：R683[医药卫生—骨科学]