骨质疏松人工骨模块中PMMA剂量及分布对螺钉稳定性的影响

发布时间：2018-04-18 02:12

本文选题：骨质疏松 + 椎弓根螺钉　；参考：《解放军医学杂志》2017年09期

【摘要】：目的比较骨质疏松人工骨模块中聚甲基丙烯酸甲酯(PMMA)骨水泥剂量对不同侧孔螺钉稳定性的影响,分析螺钉稳定性与PMMA注射剂量及分布的关系。方法将骨质疏松人工骨模块随机分为A、B、C、D四个螺钉组,每组又随机分为0、1、2、3四个剂量(0、1.0、1.5、2.0ml PMMA)组。采用相同方法制备钉道后,A C组分别拧入A、B、C三种可注射螺钉并注射不同剂量PMMA,D组向钉道内注射不同剂量PMMA后再拧入普通椎弓根螺钉。X线检查观察螺钉及PMMA分布情况;采用轴向拔出实验测量最大轴向拔出力(F_(max))。结果 X线检查结果显示,A1 A3组中PMMA包裹螺钉的前1/3,B1 B3组和C1-C3组中PMMA包裹螺钉的中1/3,D1 D3组中PMMA相对均匀地包裹螺钉的全长。两因素方差分析显示,PMMA剂量和分布两个因素对F_(max)均有显著影响(P0.05),但两个因素之间无明显的相互作用(P=0.877)。在相同螺钉组间,注射1.0ml和1.5ml PMMA组、注射1.5ml和2.0ml PMMA组的F_(max)比较差异均无统计学意义(P0.05),但注射2.0ml PMMA组的F_(max)明显高于注射1.0ml PMMA组(P0.05)。在相同剂量PMMA组间,A0 D0各组间、A2 D2各组间、A3 D3各组间F_(max)差异无统计学意义(P0.05);A1组中F_(max)明显低于D1组(P=0.026),其余各组间差异均无统计学意义(P0.05)。除A1组F_(max)明显低于D1组(P=0.026)外,其余相同剂量PMMA组间比较F_(max)差异均无统计学意义(P0.05)。结论 PMMA可显著提高骨质疏松人工骨中椎弓根螺钉的稳定性,且螺钉的稳定性与PMMA的注射剂量及分布有关。
[Abstract]:Objective to compare the effects of different dosage of PMMA cement on the stability of different lateral hole screws in osteoporosis artificial bone module, and to analyze the relationship between screw stability and injection dose and distribution of PMMA.Methods Osteoporosis artificial bone module was randomly divided into four groups: Acarinic group, each group was randomly divided into four groups: 0 1, 1, 2, 3, 0, 0, 1, 0, 1. 5 and 2. 0 ml PMMA group.Three kinds of injectable screws were inserted into the nail canal in group A and C respectively, and the distribution of screws and PMMA were observed by X-ray examination after injection of different doses of PMMA into the nail canal in group A and C respectively.The maximum axial pull-out force was measured by axial pull-out experiment.Results the results of X-ray examination showed that the length of PMMA was relatively uniform in the first 1 / 3 of PMMA wrapped screw in A1-A3 group and the middle 1 / 3 of PMMA wrapped screw in C1-C3 group in D3 group.Two-factor ANOVA analysis showed that the dose and distribution of PMMA had a significant effect on the FV max (P 0.05), but there was no significant interaction between the two factors.In the same screw group, there was no significant difference between the two groups (1.0ml and 1.5ml PMMA, 1.5ml and 2.0ml PMMA), but the 2.0ml PMMA group was significantly higher than the 1.0ml PMMA group.In the same dose of PMMA group, there was no significant difference between A2-D _ 2 group and A _ 3 / D _ 3 group. There was no significant difference between group A _ (0. 05) and group A _ (0. 05) (P < 0. 05) compared with group D1 (P < 0. 026), and there was no significant difference between other groups (P 0. 05).There was no significant difference between the same dose of PMMA group (P 0.05) except that in A1 group (P < 0.01) and D 1 group (P < 0.026).Conclusion PMMA can significantly improve the stability of pedicle screws in osteoporotic artificial bone, and the stability of screws is related to the injection dose and distribution of PMMA.
【作者单位】：成都市天府新区人民医院骨科;成都军区总医院麻醉科;成都军区总医院骨科;解放军184医院骨科;
【基金】：国家自然科学基金青年基金项目(81301606) 四川省卫生和计划生育委员会科研课题(16PJ020) 中国博士后科学基金面上项目(2016M603054) 成都军区总医院研究型人才资助项目(42412E33)~~
【分类号】：R687.3

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