小空腔技术在椎体成形术中的应用  

Application of small cavity technique during vertebroplasty

作　　者：李鸿翥 齐向北[1] 王大鹏[1] 刘士昭[1] 孙辉[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》2017年第4期650-652,共3页Chinese Journal of Experimental Surgery

基　　金：河北省自然科学基金（H2012206068）;政府资助临床医学优秀人才培养项目基金

摘　　要：目的 观察椎体成形术（PVP）中小空腔技术对骨水泥渗漏、渗漏体积以及骨水泥分布的影响。 方法 选取5具防腐尸体标本，游离T8～L5椎体，共获得50个完整椎体（2个做预实验），制成压缩骨折模型，随机分为A、B两组，每组24个，A组行传统PVP，B组行小空腔PVP。术后统计两组骨水泥渗漏例数，CT扫描分析两组骨水泥分布，同时测量两组骨水泥渗漏体积。用SPSS 21.0统计软件分析比较两组数据。 结果 A组共发生14例骨水泥渗漏（58.3%），B组发生5例骨水泥渗漏（20.8%），两组差异有统计学意义（χ2＝7.056，P＝0.008）；A组骨水泥渗漏体积为（0.77±0.06） ml，B组骨水泥渗漏体积为（0.23±0.02） ml，两组差异有统计学意义（t＝18.732，P＝0.000）；CT扫描显示：A组椎体内骨水泥分布欠佳，B组椎体内骨水泥分布较A组均匀、有规律。结论 小空腔技术在PVP中可以减少骨水泥渗漏，使骨水泥分布更加均匀。Objective To observe the effects of cavity creation on cement leakage, leakage volume and the distribution during vertebroplasty.Methods Fifty vertebrae （T8-L5） were harvested from five embalmed cadavers and made into compression fracture models, of which 2 were selected for the pre-test. And the remaining were randomized to vertebroplasty group （group A） or cavuplasty （group B）. In the group B, a small cavity was created in the vertebral body prior to cement injection. The cement leakage rate was calculated and distribution of cement was assessed with postoperative CT scan. Meanwhile, the volume of cement leakage in each group was measured quantitatively in ml.Results Cement leakage was observed in 14 （58.3%） vertebral bodies in group A and 5 （20.8%） in group B （χ2=7.056, P=0.008）. The cement leakage volume in group B [（0.23±0.02） ml] was significantly less than that in group A [（0.77±0.06） ml] （t=18.732, P=0.000）. CT scan displayed the cement distribution in group B was more uniform with greater regularity than that in group A. Conclusion The creation of a small cavity in the vertebral body prior to cement injection is an effective way to reduce cement leakage and make cement distribution more uniform during vertebroplasty.

关 键 词：小空腔技术 椎体成形术 骨水泥 渗漏 

分 类 号：R687[医药卫生—骨科学]