骨质疏松山羊椎体骨水泥强化后对其相邻椎体生物力学的影响  

Biomechanical effects of cement-augmented vertebral body on its adjacent vertebral bodies in osteoporosis goat model

作　　者：汤杰 蔡海康[2] 徐镇[2] 王振卿 周皓 钟务学 Tang Jie;Cai Haikang;Xu Zhen;Wang Zhenqing;Zhou Hao;Zhong Wuxue(Department of Graduate School,Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang,China;Department of Orthopaedics,Shanghai Xuhui Central Hospital,Shanghai 200031,China)

机构地区：[1]浙江中医药大学研究生院,杭州310053 [2]上海市徐汇区中心医院骨科,上海200031

出　　处：《脊柱外科杂志》2023年第1期44-49,共6页Journal of Spinal Surgery

基　　金：上海市徐汇区医学科研项目(SHXH202007)。

摘　　要：目的分析骨质疏松山羊椎体强化后对椎体刚度、应变及相邻椎体上下终板应力的影响,探讨椎体强化是否为相邻椎体骨折的潜在高危因素。方法将12只骨质疏松山羊随机分为实验组和对照组,每组6只,实验组行L_(1)椎体强化术、术中以聚甲基丙烯酸甲酯(PMMA)骨水泥强化椎体,对照组不进行手术。术后1周取2组山羊T_(12)~L_(3)标本行生物力学测试。使用Aramis三维运动和变形测量系统获取轴向加压400 N时T_(13)、L_(1)、L_(2)椎体的应变,同时获得T_(13)、L_(1)、L_(2)椎体的相对位移,通过载荷-位移曲线获得T_(13)、L_(1)、L_(2)椎体的刚度。设定实验载荷为轴向400 N,分别检测T_(13)下终板及L_(2)上终板所受的应力。结果实验组L_(1)应变比对照组降低、刚度比对照组增加,差异均有统计学意义(P<0.05)。实验组T_(13)和L_(2)应变比对照组增加,T_(13)下终板及L_(2)上终板应力比对照组增加,差异均有统计学意义(P<0.05);实验组T_(13)下终板应力较L_(2)上终板大,差异有统计学意义(P<0.05)。结论骨质疏松山羊椎体使用骨水泥强化后其相邻椎体的生物力学发生改变,是术后相邻椎体骨折的潜在高危因素。Objective To analyze the influence of vertebral augmentation on the vertebral stiffness and strain,and stress of the upper and lower endplates of adjacent vertebrae in osteoporotic goats for exploring whether vertebral augmentation is a potential risk factor for adjacent vertebral fracture.Methods The 12 osteoporotic goats were randomly divided into experimental group and control group,with 6 goats in each group.The experimental group received L_(1)vertebroplasty,and the vertebral body was strengthened with polymethyl methacrylate(PMMA)bone cement during the operation,while the control group did not receive surgery.A biomechanical test was performed on the T_(12)-L_(3)segments for both groups 1 week after operation.The Aramis three-dimensional motion and deformation measurement system were used to obtain the strain of T_(13),L_(1)and L_(2)vertebrae under axial compression of 400 N,and the relative displacement of T_(13),L_(1)and L_(2)vertebrae was obtained at the same time.The stiffness of T_(13),L_(1)and L_(2)vertebrae was obtained through the load-displacement curve.With the augmentation load of 400 N in the axial direction,the stress on the T_(13)lower endplate and the L_(2)upper endplate was measured.Results The L_(1)strain in the experimental group was lower than that in the control group,and the stiffness was higher than that in the control group,with a statistically significant differences(P<0.05).The strain of T_(13)and L_(2)in the experimental group was higher than that in the control group,and the stress of T_(13)lower endplate and L_(2)upper endplate was higher than that in the control group,and the differences were statistically significant(P<0.05).The stress of T_(13)lower endplate was greater than that of L_(2)upper endplate in the experimental group,and the difference was statistically significant(P<0.05).Conclusion After vertebral augmentation with bone cement in the osteoporotic goats,the biomechanics of the adjacent vertebrae would be changed,which is a potential high-risk factor for the postope

关 键 词：骨质疏松 骨黏合剂 甲基丙烯酸甲酯类 生物力学 山羊 

分 类 号：R681.4[医药卫生—骨科学]