新型可灌注骨水泥椎弓根螺钉的生物力学性能及在骨质疏松性腰椎退变中的应用

发布时间：2018-02-02 20:19

  本文关键词： 腰椎 骨质疏松 生物力学 组织工程 骨科植入物 脊柱植入物 腰椎退变 骨水泥 椎弓根螺钉 轴向拔出力 旋出力矩 稳定性　出处：《中国组织工程研究》2016年31期 　论文类型：期刊论文

【摘要】：背景:老年性骨质疏松患者由于机体骨质的脆弱,容易造成椎弓根螺钉固定能力得到进一步削弱。因此骨质疏松性腰椎退变患者采用椎弓根螺钉修复时骨水泥渗漏以及螺钉取出量等问题难以解决。目的:探讨新型可灌注骨水泥椎弓根螺钉的生物力学性能及在骨质疏松性腰椎退变患者中的应用效果。方法:选取完整浸润腰椎标本(T11-L5)6具,平均年龄(72.9±4.2)岁,共42个椎体,平均骨密度为0.696 g/cm2。所有椎体任意选取一侧椎弓根置入可灌注骨水泥椎弓根螺钉,采用水泥推杆和灌注筒在X射线透视下灌注2 mL骨水泥;在椎体标本对侧置入相同数目常规螺钉。对2种螺钉进行三点弯曲实验,对选取椎体进行最大轴向拔出力实验及最大旋出力矩实验,观察椎体的破坏情况及螺钉置入效果。结果与结论:(1)新型可灌注骨水泥椎弓根螺钉极限强度、屈服载荷均显著大于常规螺钉(P0.05);极限位移和屈服位移均显著小于常规螺钉(P0.05);(2)新型可灌注骨水泥椎弓根螺钉的轴向拔出力及最大旋出力矩均显著高于常规螺钉(P0.05);(3)综上所述,新型可灌注骨水泥椎弓根螺钉操作简单,能够有效的控制骨水泥渗透,提高螺钉在骨质疏松椎体内的稳定性,且治疗后螺钉取出相对方便,不会对椎体和钉道产生明显的破坏,促进机体早期恢复。
[Abstract]:Background: elderly patients with osteoporosis due to the fragile body bone. It is easy to reduce the fixation ability of pedicle screw further. Therefore, it is difficult to solve the problems of cement leakage and the amount of screw removal in patients with osteoporotic lumbar degenerative lumbar vertebrae using pedicle screw repair. To investigate the biomechanical properties of a new type of perfusible cement pedicle screw and its application in patients with osteoporosis lumbar degenerative. Methods: the intact infiltrated lumbar vertebrae specimens were selected. T11-L5: 6. The mean age was 72.9 卤4.2 years old, 42 vertebrae, the average bone density was 0.696 g / cm ~ (-2). 2 mL bone cement was infused with cement push rod and pouring tube under X-ray fluoroscopy. The same number of conventional screws were placed on the opposite side of the vertebrae specimens. Three point bending tests were carried out on the two kinds of screws, and the maximum axial pull-out force and the maximum spin-out moment were tested on the selected vertebrae. Results and conclusion the ultimate strength and yield load of the new type of perfusible cement pedicle screws were significantly higher than that of the conventional screws (P 0.05). The ultimate displacement and yield displacement are significantly lower than the conventional screw P0.05; (2) the axial pull-out force and the maximum spin-out moment of the new rechargeable cement pedicle screws were significantly higher than those of the conventional screws (P 0.05). In conclusion, the new type of cement pedicle screw is easy to operate, can effectively control the osseous penetration, improve the stability of the screw in the osteoporotic vertebral body, and the screw removal is relatively convenient after treatment. There is no obvious damage to the vertebral body and the nail canal, and promote the early recovery of the body.
【作者单位】： 三峡大学第一临床医学院宜昌市中心人民医院脊柱外科三峡大学脊柱医学与创伤研究所;
【分类号】：R687.3;R580
【正文快照】： 文章快速阅读:新型可灌注骨水泥椎弓根螺钉修复骨质疏松性腰椎退变的生物力学特性目的:方法:观察指标:观察新型可灌注骨水泥椎选取完整浸润腰椎标本(T11-L5)6具,对2种螺钉进行三点弯曲弓根螺钉在骨质疏松性退平均年龄(72.9±4.2)岁,所有椎体一侧实验,对选取椎体进行最变腰椎中，

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