兔模型行经皮椎体成形术和经皮椎体后凸成形术术后腰椎生物力学功能改变的实验研究

发布时间：2018-11-02 08:19

【摘要】：目的研究在兔骨质疏松模型中行经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)对模型腰椎生物力学功能的影响。方法将新西兰大白兔通过切除双侧卵巢建立骨质疏松模型,造模成功58例,分为两组,A组29只,予以行PVP手术,B组29只,予以行PKP手术,观察两组模型术后椎体弯曲和压缩实验最大载荷量的变化,椎体术后平均高度和矢状面Cobb角的改变。结果两组兔模型行PKP和PVP术后,椎体承载压力能力得到了显著提升,差异较手术前具有显著的统计学意义(P0.01),B组术后椎体承载压力能力提高较A组明显,其差异具有统计学意义(P0.05)。但术后6、12和18个月两组模型承载压力能力逐渐下降。术后观察18个月,A组手术椎体术后平均高度和矢状面Cobb角与术前相比,差异无统计学意义(P0.05),B组模型18个月后手术椎体前缘平均高度由术前(38.81±8.12)%恢复至(80.17±16.38)%,矢状面Cobb角由术前(30.13±8.75)°恢复至(8.69±3.45)°。B组椎体术后高度测量值和Cobb角的变化与A组相比,差异具有统计学差异(P0.05)。A组6个月后手术部位邻近椎体新发骨折率为20.69%,12个月后为24.14%,18个月后为31.03%;B组6和12个月后均为3.45%,18个月后为6.90%,在新发邻椎骨折方面,PKP优于PVP(P0.05)。结论 PKP可更好地改善后凸角度,更显著地改善椎体承载压力的能力;减少新发邻近椎体骨折的发生率,但尚需更多设计严谨的随机对照研究加以证实。
[Abstract]:Objective to study the effects of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) on the biomechanical function of lumbar vertebrae in a rabbit model of osteoporosis. Methods New Zealand white rabbits were divided into two groups: group A (n = 29) underwent PVP operation, group B (n = 29), and group B (n = 29) underwent PKP operation. The changes of the maximum load, the average height and the sagittal Cobb angle of the two groups were observed. Results after PKP and PVP, the vertebral bearing pressure capacity of the two groups was significantly improved, and the difference was statistically significant compared with that before operation (P0.01), B group increased the vertebral bearing pressure ability significantly than that of A group. The difference was statistically significant (P0.05). However, the load-carrying capacity of the two groups decreased gradually at 6: 12 and 18 months postoperatively. After 18 months of operation, the average height and sagittal Cobb angle in group A were not significantly different from those before operation (P0.05). In group B, the average height of the anterior edge of the vertebral body recovered from (38.81 卤8.12)% to (80.17 卤16.38)% after 18 months of operation. The sagittal Cobb angle recovered from (30.13 卤8.75) 掳to (8.69 卤3.45) 掳. The changes of height and Cobb angle in group B were compared with those in group A. The difference was statistically significant (P0.05) the rate of new fracture near the vertebral body in the). A group was 20.69 after 6 months, 24.14 after 12 months, and 31.033 after 18 months. In group B, it was 3.45 after 6 months and 12 months, and 6.90 after 18 months. PKP was superior to PVP in the fracture of new adjacent vertebrae (P0.05). Conclusion PKP can improve the kyphosis angle and the capacity of bearing pressure of vertebral body, and reduce the incidence of new vertebral fracture, but it needs to be confirmed by more and more well-designed randomized controlled studies.
【作者单位】：福建医科大学省立临床医学院;福建省立医院骨一科;
【分类号】：R687.3;R-332

【参考文献】