本文選題：骨質(zhì)疏松 + 胸椎　； 參考：《中國組織工程研究》2017年10期

【摘要】：背景:研究表明,骨質(zhì)疏松常導(dǎo)致椎弓根螺釘內(nèi)固定失敗。采用普通椎弓根螺釘固定骨質(zhì)疏松椎體達不到堅強的穩(wěn)定性,需要采取特殊強化措施。目的:評價骨水泥強化聯(lián)合可膨脹椎弓根螺釘對骨質(zhì)疏松性胸腰椎穩(wěn)定性的影響。方法:將20個骨質(zhì)疏松性人胸腰椎椎體標(biāo)本隨機分為4組,普通椎弓根釘組置入普通椎弓根螺釘,其余3組均置入可膨脹椎弓根螺釘;可膨脹椎弓根釘組不進行骨水泥強化,聚甲基丙烯酸甲酯骨水泥強化組及硫酸鈣骨水泥強化組于釘?shù)纼?nèi)分別注入聚甲基丙烯酸甲酯骨水泥及硫酸鈣骨水泥之后再置入可膨脹椎弓根釘。選擇一側(cè)椎弓根,測試椎弓根螺釘?shù)淖畲筝S向拔出力及屈服能量吸收值(對螺釘?shù)奈樟?;選擇另一側(cè)椎弓根,測試最大旋出力矩;并觀察骨水泥強化后的骨水泥滲漏情況。結(jié)果與結(jié)論:(1)與普通椎弓根釘組相比,其余3組的最大軸向拔出力、最大旋出力矩及屈服能量吸收值均顯著增加(P0.05),且2個骨水泥強化組顯著大于可膨脹椎弓根釘組及普通椎弓根釘組(P0.05),2個骨水泥強化組之間差異無顯著性意義(P0.05);(2)骨水泥強化后未發(fā)生骨水泥滲漏現(xiàn)象;(3)結(jié)果表明,骨水泥強化聯(lián)合可膨脹椎弓根螺釘可顯著增強骨質(zhì)疏松胸腰椎椎體的穩(wěn)定性,聚甲基丙烯酸甲酯骨水泥與硫酸鈣骨水泥效果相似。
[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.
【作者單位】： 西南醫(yī)科大學(xué)附屬醫(yī)院脊柱外科;西南醫(yī)科大學(xué)附屬醫(yī)院影像科;瀘州市人民醫(yī)院骨科;簡陽市人民醫(yī)院;
【基金】：西南醫(yī)科大學(xué)附屬醫(yī)院科研項目(15073) 西南醫(yī)科大學(xué)科研項目(2015-YJ021) 瀘州市科技計劃項目(2016-R-70(18/24)) 四川省衛(wèi)生和計劃委員會科研課題(2016PJ552)~~
【分類號】：R580;R687.3
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本文編號：1959662