弹性弧形骨钻对小牛椎体骨质疏松模型PVP术中骨水泥分布的影响  

Effect of elastic curved bone drill unit on the distribution of bone cement during percutaneous vertebroplasty in the calf osteoporotic vertebral model

作　　者：王新虎[1] 张军[1] 刘夏君[1] 姚福东[1] 杜伟[1] 谢恩[2] 

机构地区：[1]宝鸡市中心医院脊柱外科,陕西宝鸡721008 [2]西安市红十字会医院脊柱外科,西安710054

出　　处：《中国骨质疏松杂志》2014年第9期1062-1065,共4页Chinese Journal of Osteoporosis

摘　　要：目的探讨自制弹性弧形骨钻在小牛椎体骨质疏松模型上行PVP术的可行性,并观察其对骨水泥分布的影响。方法采用乙二胺四乙酸二钠盐(EDTA-Na2)浸泡法制备小牛体外骨质疏松椎体,将40个骨质疏松椎体随机分为A、B两组,每组各20个椎体行椎体成形术,A组行常规直钻穿刺,B组采用自制弹性弧形骨钻穿刺,弧形方向朝向穿刺对侧,深度达到椎体中前三分之一终止,对两组穿刺骨钻及骨水泥是否达到或越过椎体矢状中线进行统计分析。结果 EDTA-Na2浸泡法脱钙9 d时成功制备出体外骨质疏松椎体,直钻穿刺组钻头达到或越过椎体矢状中线有7个椎体,骨水泥分布达到或越过椎体矢状中线11个;弹性弧形骨钻组穿刺钻头达到或越过椎体矢状中线有18个椎体,骨水泥分布达到或越过椎体矢状中线19个,两组骨钻穿刺效果及骨水泥分布上的差异有统计学意义(P<0.05)。A组9个椎体发生骨水泥椎管内渗漏,B组4个椎体发生骨水泥椎管内渗漏,两组间在骨水泥渗漏上无显著性差异(P>0.05)。结论采用自制弹性弧形骨钻在小牛骨质疏松模型上可以顺利实施PVP术,且能实现单侧椎弓根穿刺,骨水泥双侧分布的效果。Objective To explore the practicable value of elastic curved bone drill unit performing percutaneous vertebroplasty in calf osteoporotic vertebral model, and to observe its effect on the distribution of bone cement.Methods The calf osteoporotic vertebral model was established using EDTA-Na2 immersion method.Forty osteoporotic vertebrae were randomly divided into 2 groups：group A and group B.Each group had 20 vertebrae for vertebroplasty.Vertebrae in group A underwent routine straight bone drill puncture, while vertebrae in group B underwent puncture using self made elastic curved bone drill unit.The puncture arc direction was toward the other side, with the depth of the first 1/3 termination of the vertebral body.Whether the puncture bone drill and bone cement achieved or crossed over the sagittal midline in two groups was analyzed.Results After 9-day immersion and decalcification with EDTA-Na2 , the osteoporotic vertebral model was successfully established in vitro.In group A, the drill bit reached or crossed over vertebral sagittal midline in 7 vertebral bodies, and the bone cement distributed beyond the vertebral sagittal midline in 11 vertebral bodies.In group B, the drill bit reached or crossed over vertebral sagittal midline in 18 vertebral bodies, and the bone cement distributed beyond the vertebral sagittal midline in 19 vertebral bodies.The effect of drilling and distribution of bone cement between the 2 groups had statistical significance （ P〈0.05） .Nine vertebral bodies in group A had intraspinal bone cement leakage, while 4 had in group B, and no significant difference between group A and B was observed （P〉0.05）.Conclusion The self made elastic curved bone drill unit can build an osseous channel that reaches or beyond the vertebral sagittal midline through only one side transpedicular puncture, then guiding bone cement to distribute to the other lateral pedicle, which can avoid the disadvantage of bilateral pedicle puncture.

关 键 词：椎体成形术 骨质疏松 压缩骨折 骨钻 动物实验 小牛椎体 

分 类 号：R681.5[医药卫生—骨科学]