摘要
目的探讨单侧与双侧椎体后凸成形术（PKP）在恢复骨质疏松压缩性骨折椎体刚度中的差异，以及骨水泥分布对椎体两侧力学平衡的影响。方法将27个胸椎椎体制作成从缩性骨折模型，随机分为3组（每组9个椎体）：经单侧椎弓根PKP且骨水泥填充局限于椎体半侧组（A组）、经单侧椎弓根PKP且骨水泥填充超过中线组（B组）及经双侧椎弓根PKP组（C组）、采用MTS材料测试系统对所有椎体在3个不同时相中（完整状态、骨水泥强化前、骨水泥强化后）进行压缩试验。记录力和位移随时间变化的数据，比较椎体各时相、各部位的刚度值。结果B组有1个椎体、C组有2个椎体被损坏，予以剔除．骨水泥强化前3组椎体标本的整体刚度较完整状态均显著下降，差异有统计学意义（P〈0．05）。骨水泥强化后，3组均可显著增加椎体的整体刚度，A组和B组刚度值[（251．37±23．34）、（250．41±21．27）N／m]与完整状念时的刚度水平[（260．48±34．15）、（257．60±31．44）N／m]比较差异无统计学意义（P〉0．05）；而C组强化后的刚度值[（280．88±37．54）N／ml高于完整状态水平[（246．20±43．74）N／m]（P〈0．05）。骨水泥强化后，A组强化侧的刚度值可以恢复至完整状念水平，且显著高于非强化侧，差异有统计学意义（P〈0．05）。B组和C组椎体均可以均衡恢复两侧的刚度（P〉0．05）。结论 单侧与双侧PKP均可恢复压缩性骨折椎体的整体刚度。当骨水泥填允超过中线时，单侧PKP可以与双侧PKP一样使椎体两侧刚度得到均衡提高。
Objective To compare the efteels of tmipedicolar and bipedieular pereutaneous kyphoplasties （PKP） on stiffness of the compression-fraetured vertet）ral bodies （VBs）, anti h） assess the effect of cement distribution on hilateral biomechanieal balanee nf the VBs following PKP. Methods Twenty-seven VBs were made into models of compression-fracture and randomly assigned into 3 equal groups. Group A was treated with unipedieular PKP anti eement augmentation limited to hemivertebral bodies, group B with unipedieular PKP and cement augmentation beyond the midline and onto the nnn-punctured side, and group C with bipedieular PKP. All the vertebrae and bilateral sides of the vertebrae were tested, on the MTS 858 binnix Ⅱ maehine （USA）, under continuous axial loads at intact, pre-augmentation and pnst-augmentation phases, respectively. The changes in force and displacement were recorded to calculate the stiffness values of the whole vertebrae and their bilateral sides at different sites and phases. Results One VB in group B and 2 VBs in group C were excluded due t. damage. The stiffness values in groups A, B. and C were signifieantly decreased before augmentation compared to their intact state, anti significantly increased after augmentation （ P 〈0. 05）, lint the stiffness value in groups A and B were comparable to their intact state （P 〉 0.05） while the stiffness value in group C was significantly higher then its intact state （ P 〈 0. 05）. In group A, stiffness of the augmented side was restored to its intact state after cement augmentation and significantly superior to that of the non-augmented side （ P 〈 0.05） . In groups B and C, the stiffiless values at the bilateral sides were restored in balanee （ P 〉 0.05）. Conclusions Both unipedieular and hipedieular PKPs can restore the whole stiffness of the fractured VBs. In unipedieular PKP, when cement is augmented beyond the midline anti adequately fills the other side, the stiffness at both sides can he as well restored in bal
出处
《中华创伤骨科杂志》
CAS
CSCD
2011年第3期251-255,共5页
Chinese Journal of Orthopaedic Trauma
基金
广东省科技计划资助项目（2009B030803034）
关键词
脊柱骨折
胸椎
生物力学
椎体后凸成形术
Spinal fractures
Thoracic vertebrae
Biomeehanies
Pereutanenus kyphoplasty
