可膨胀椎弓根钉骨水泥强化与骨质疏松性胸腰椎固定强度的关系

发布时间：2018-05-31 12:22

  本文选题：骨质疏松 + 胸椎　； 参考：《中国组织工程研究》2017年10期

【摘要】：背景:研究表明,骨质疏松常导致椎弓根螺钉内固定失败。采用普通椎弓根螺钉固定骨质疏松椎体达不到坚强的稳定性,需要采取特殊强化措施。目的:评价骨水泥强化联合可膨胀椎弓根螺钉对骨质疏松性胸腰椎稳定性的影响。方法:将20个骨质疏松性人胸腰椎椎体标本随机分为4组,普通椎弓根钉组置入普通椎弓根螺钉,其余3组均置入可膨胀椎弓根螺钉;可膨胀椎弓根钉组不进行骨水泥强化,聚甲基丙烯酸甲酯骨水泥强化组及硫酸钙骨水泥强化组于钉道内分别注入聚甲基丙烯酸甲酯骨水泥及硫酸钙骨水泥之后再置入可膨胀椎弓根钉。选择一侧椎弓根,测试椎弓根螺钉的最大轴向拔出力及屈服能量吸收值(对螺钉的握力);选择另一侧椎弓根,测试最大旋出力矩;并观察骨水泥强化后的骨水泥渗漏情况。结果与结论:(1)与普通椎弓根钉组相比,其余3组的最大轴向拔出力、最大旋出力矩及屈服能量吸收值均显著增加(P0.05),且2个骨水泥强化组显著大于可膨胀椎弓根钉组及普通椎弓根钉组(P0.05),2个骨水泥强化组之间差异无显著性意义(P0.05);(2)骨水泥强化后未发生骨水泥渗漏现象;(3)结果表明,骨水泥强化联合可膨胀椎弓根螺钉可显著增强骨质疏松胸腰椎椎体的稳定性,聚甲基丙烯酸甲酯骨水泥与硫酸钙骨水泥效果相似。
[Abstract]:Background: studies have shown that osteoporosis often results in failure of pedicle screw fixation. Ordinary pedicle screw fixation of osteoporotic vertebral body can not achieve strong stability, so special strengthening measures are needed. Objective: to evaluate the effect of bone cement augmentation combined with expandable pedicle screw on the stability of osteoporotic thoracolumbar vertebrae. Methods: twenty osteoporotic human thoracolumbar vertebrae specimens were randomly divided into 4 groups: the common pedicle screw group was placed with the common pedicle screw, the other three groups were all implanted the expandable pedicle screw, and the expandable pedicle screw group was not reinforced with bone cement. Polymethyl methacrylate cement reinforced group and calcium sulfate bone cement reinforcement group were injected with polymethyl methacrylate bone cement and calcium sulfate bone cement respectively into the nail canal and then were placed with expandable pedicle nail. The maximum axial pull-out force and yield energy absorption of pedicle screw were measured by selecting one side of pedicle screw (grip force on screw), the maximum rotation moment was measured by selecting the other pedicle, and the leakage of bone cement was observed. Results compared with the common pedicle screw group, the maximum axial pull-out force of the other three groups was higher than that of the common pedicle screw group. The maximum spin-out moment and yield energy absorption value were significantly increased in the two bone cement strengthening groups than in the expandable pedicle screw group and the common pedicle screw group. There was no significant difference between the two cement strengthening groups. The results showed that the cement leakage did not occur after reinforcement. Bone cement combined with expandable pedicle screw can significantly enhance the stability of osteoporotic thoracolumbar vertebrae. The effect of polymethyl methacrylate bone cement is similar to that of calcium sulfate bone cement.
【作者单位】： 西南医科大学附属医院脊柱外科;西南医科大学附属医院影像科;泸州市人民医院骨科;简阳市人民医院;
【基金】：西南医科大学附属医院科研项目(15073) 西南医科大学科研项目(2015-YJ021) 泸州市科技计划项目(2016-R-70(18/24)) 四川省卫生和计划委员会科研课题(2016PJ552)~~
【分类号】：R580;R687.3
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本文编号：1959662