椎体成形术中最小骨水泥注入量的研究  

Exerperimental study on the minimum cement volume in vertebroplasty

作　　者：李军科[1] 齐向北[1] 黄习彬 高守达 王大鹏[1] 

机构地区：[1]河北医科大学第三医院骨科河北省骨科生物力学重点实验室,石家庄050051

出　　处：《中华实验外科杂志》2016年第1期192-194,共3页Chinese Journal of Experimental Surgery

基　　金：河北省自然科学基金（H2012206068）

摘　　要：目的探讨在椎体成形术中恢复骨折椎体刚度所需注入骨水泥最小百分比。方法选用15个防腐椎体标本经生物力学机压缩制备椎体骨折模型。在同一骨折椎体上连续3次注射，第1次通过左侧椎弓根注入骨折椎体体积5％骨水泥，第2次通过同侧椎弓根注人骨折椎体体积5％骨水泥，共计10％，第3次通过右侧椎弓根注入骨折椎体体积5％骨水泥，共计15％。骨折前、后及每次骨水泥注入后进行生物力学实验。采用重复测量设计的方差分析和配对t检验，比较连续5个时相的刚度。结果椎体骨折后，刚度降低为骨折前的56％，5％骨水泥注入后，恢复到70％；10％骨水泥注入后，恢复到89％，15％骨水泥注入后，恢复到91％。5％骨水泥注入与10％比较，刚度变化差异有统计学意义（P〈0．05），但10％骨水泥注入和15％比较，刚度变化差异无统计学意义（P〉0．05）。结论在椎体成形术中，骨折椎体刚度随骨水泥注入量的增加而增加，恢复骨折椎体刚度最小骨水泥注入量为骨折椎体体积的10％，在胸腰段为2～4ml骨水泥。Objective To study the minimum percentage of bone cement fill volume restoring vertebral stiffness in vertebroplasty. Methods Fifty vertebral body specimens were selected to made into compression fracture models by the biomeehanical machine for further test. After fracture vertebroplasty was performed, 3 times in the same fracture vertebral body. The first bone cement of 5% of fractured vertebral body volume was injected through the left pediele and the second 5% （ combined 10% ） via the same pedicle. The manoeuvre was performed for the third （ combined 15% ） through the right pedicle. The biome- ehanical testing was carried out before and after the fracture, and after each cement injection. The repeated measures analysis of variance and the paired test were carried out in five consecutive time points. Results After vertebral fracture stiffness was reduced to 56% compared to the pre -fracture level, and was partially restored to 70% after 5% bone cement fill; 10% was partially restored to 89% ; and 15% was partially restored to 91%. There was statistically significant difference between 5% bone cement fill and 10% （P 〈 0. 05）, but there was no significant difference between 10% bone cement fill and 15% （P 〉0.05）. Conclusion The fracture vertebral body stiffness increases with the increase of bone cement filling rate for vertebroplasty. 10% of bone cement fill was the limit beyond which no substantial increase in compressive stiffness and is the minimum volume of cement for vertebroplasty. In the average thoracolumbar vertebra this means 2 -4 ml of bone cement.

关 键 词：椎体成形术 骨水泥体积 生物力学 骨水泥渗漏 

分 类 号：R683.2[医药卫生—骨科学]