贵州医科大学学报

2016, v.41;No.188(05) 610-614

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经皮椎体成形骨水泥注入对腰椎生物力学的影响
Effect of Percutaneous Kyphoplasty on Biomechanical Function of Adjacent Lumbar Vertebrae

谭斌;周道政;
TAN Bin;ZHOU Daozheng;Department of Orthopedic Surgery,People's Hospital of Kai County;

摘要(Abstract):

目的:观察经皮椎体后凸成形骨水泥注入对骨质疏松兔模型邻近腰椎生物力学功能的影响。方法:切除36只雌性新西兰大白兔双侧卵巢,建立L3骨质疏松骨折动物模型,造模成功后随机均分为试验组和对照组2组,试验组行经皮椎体后凸成形术(PKP),对照组行开放复位内固定手术,术后5、10、15个月检测骨密度值、椎体弯曲和压缩实验最大载荷量、椎体术后平均高度以及矢状面Cobb角。结果:试验组术后5、10及15个月的骨密度分别为(0.073 2±0.008 1)、(0.070 8±0.008 0)及(0.067 5±0.006 3)g/cm~2,均显著高于对照组,差异有统计学意义(P<0.05);试验组15个月后手术椎体前缘和后缘平均高度分别由术前(38.34±4.23)%和(49.85±4.43)%恢复至(81.53±8.32)%和(60.16±6.28)%,矢状面Cobb角由术前(30.16±4.15)°恢复至(8.53±2.26)°;试验组不同时间点的骨密度值、椎体弯曲和压缩实验最大载荷量、椎体前缘与后缘高度均高于术前,矢状面Cobb角低于术前,差异具有统计学意义(P<0.05);对照组不同时间点的骨密度值、椎体弯曲和压缩实验最大载荷量高于术前(P<0.05),椎体前缘与后缘高度、矢状面Cobb角与术前比较,差异无统计学意义(P>0.05);试验组术后不同时间点的骨密度值、椎体弯曲和压缩实验最大载荷量、椎体前缘与后缘高度均高于对照组,矢状面Cobb角低于对照组,差异有统计学意义(P<0.05)。结论:PKP可改善骨质疏松骨折邻近椎体的骨密度、承载能力、及椎体后凸角度。
Objective: To observe the effect of percutaneous kyphoplasty( PKP) on biomechanical function of adjacent lumbar vertebrae in rabbit osteoporosis model. Methods: 36 female New Zealand white rabbits were ovariectomized to establish L3 animal model of osteoporotic fracture and randomly divided into control group( treated with open reduction and internal fixation operation) and experimental group( treated with PKP operation). 5,10,15 months after operation,the bone mineral density,maximum load of vertebra bending and compression,average vertebra height and the sagittal Cobb angle of vertebra were detected and compared between two groups. Results: The bone mineral density of experimental group 5 months,10 months and 15 months after operation were( 0. 073 2 ± 0. 008 1) g /cm~2,( 0. 070 8 ± 0. 008 0) g /cm~2and( 0. 067 5 ± 0. 006 3) g / cm~2,all of which were significantly higher than those of control group( P < 0. 05). In experimental group,15 months after surgery,the average height of anterior and posterior margin of vertebral body return from preoperative( 38. 34 ±4. 23) % and( 49. 85 ± 4. 43) % to postoperative( 81. 53 ± 8. 32) % and( 60. 16 ± 6. 28) %. The sagittal Cobb angle of vertebra returned from preoperative( 30. 16 ± 4. 15) ° to postoperative( 8. 53 ±2. 26) °. In experimental group,the bone mineral density,maximum load of vertebra bending and compression and the average height of anterior and posterior margin of vertebral body at different time points after surgery were significantly higher than their counterparts before surgery while the sagittal Cobb angle of vertebra after surgery was lower than that before surgery( P < 0. 05). In control group,the bone mineral density,maximum load of vertebra bending and compression at different time points after surgery were significantly higher than their counterparts before surgery( P < 0. 05),but there were no statistical differences in the average height of anterior and posterior margin of vertebral body and the sagittal Cobb angle of vertebra between before surgery and after surgery( P > 0. 05). Compared with control group,the bone mineral density,maximum load of vertebra bending and compression and the average height of anterior and posterior margin of vertebral body in experimental group were significantly higher while the sagittal Cobb angle was significantly lower( P < 0. 05). Conclusion: Percutaneous kyphoplasty can improve bone mineral density,load capability and kyphosis angle of adjacent lumbar vertebrae in osteoporotic fracture.

关键词(KeyWords): 兔;脊柱骨折;生物力学;经皮椎体后凸成形术;开放复位内固定术
rabbits;spinal fractures;biomechanics;percutaneous kyphoplasty;open reduction and internal fixation;biodynamics

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作者(Author): 谭斌;周道政;
TAN Bin;ZHOU Daozheng;Department of Orthopedic Surgery,People's Hospital of Kai County;

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DOI: 10.19367/j.cnki.1000-2707.2016.05.031

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