| 椎弓根融合器添加磷酸钙骨水泥后的生物力学效果 |
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Received:April 25, 2006
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| 作者 | Author | 单位 | Unit | E-Mail |
| 胡勇 |
HU Yong, |
宁波市第六医院脊柱外科,浙江宁波315040 |
6 Hospital,Ningbo 315040,Zhejiang,China |
huyong610@163.com |
| 谢辉 |
XIE Hui |
宁波市第六医院脊柱外科,浙江宁波315040 |
6 Hospital,Ningbo 315040,Zhejiang,China |
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| 杨述华 |
YANG Shu-hua |
华中科技大学同济医学院附属协和医院骨科 |
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| 徐荣明 |
XU Rong-ming |
宁波市第六医院脊柱外科,浙江宁波315040 |
6 Hospital,Ningbo 315040,Zhejiang,China |
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| 章伟文 |
ZHANG Wei-wen |
宁波市第六医院脊柱外科,浙江宁波315040 |
6 Hospital,Ningbo 315040,Zhejiang,China |
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| 冯建翔 |
FENG Jian-xiang |
宁波市第六医院脊柱外科,浙江宁波315040 |
6 Hospital,Ningbo 315040,Zhejiang,China |
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| 付德皓 |
FU De-hao |
华中科技大学同济医学院附属协和医院骨科 |
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| 期刊信息：《中国骨伤》2007年20卷，第2期，第103-105页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目:宁波市江东区科技计划项目(编号:200431006) |
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目的:评价磷酸钙骨水泥(calcium phosphate cement,CPC)强化和修复椎弓根融合器的生物力学效果。
方法:8具成人新鲜腰椎骨L1-L4共32个椎体,随机选取其中20个,分为3组(A,B,C),每组10个。A组(对照组):随机选择10个椎体双侧椎弓根放置直径为6.5mm的椎弓根融合器,不穿透椎体前侧骨皮质。在材料实验机上进行椎弓根融合器最大轴向拔出力(Fmax)实验,拔出速率为5mm/min。B组(修复组):对照组拔出椎弓根融合器后再向椎弓根融合器中空部分注入配制好CPC3-5ml,室温(28℃)1h后再行前述最大轴向拔出力(Fmax)实验。C组(强化组):另选10个椎体直接向椎弓根融合器中空部分注入配制好CPC和拧入椎弓根融合器,再行拔出实验。沿椎弓根融合器方向锯开标本,观察CPC在椎体中分布范围。另外10个椎体作椎弓根融合器的递增负荷的周期抗屈实验。
结果:正常对照组椎弓根融合器Fmax为(843.1±132.2)N,修复组为(1456.2±239.9)N,强化组为(1499.5±241.2)N;向椎弓根融合器中空部分注入CPC,未见CPC溢出椎弓根外或椎管内。周期抗屈实验中,添加CPC可使椎弓根融合器耐受更大的负荷或在同等负荷下仅产生较小的位移。CPC骨水泥强化和修复椎弓根融合器后轴向拔出力明显高于强化前,差异具有显著性意义(P<0.05)。
结论:沿椎弓根融合器中空部分注入CPC可显著增加椎弓根螺钉的稳定性,并能减少CPC向椎弓根外或椎管内溢出。在活体中即使不添加CPC也有利于骨细胞长入椎弓根融合器侧孔,同样可以增加螺钉的稳定性。适用于螺钉松动和拔出的修复固定。 |
| [关键词]:腰椎 椎弓根 内固定器 骨水泥 生物力学 |
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| Augmentation of fusion equipment of pedicle of vertebrae with calcium phosphate cement:An in vitro biomechanical study |
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Abstract:
Objective: To evaluate the biomechanical efficacy of calcium phosphate cement(CPC) in augmentation and restoration of fusion equipment of pedicle of vertebrae(FEPV).
Methods: Ten fresh lumbar vertebrae of eight adult cadavers were employed in this experiment.Twenty out of 32 specimens were randomly divided into three groups(A,B,C),each group included ten vertebrae(L1 to L4).Group A(control group):The FEPV were implanted into the pedicle bilateral.The FEPV were not penetrated the anterior cortex of the vertebral bodies.The FEPV were pulled out from the vertebrae at 5 mm/min.Group B(restoration group):The bilateral FEPV track were filled with 3 to 5 ml of CPC).Then,the FEPV were implanted bilaterally,and the CPC was allowed to harden for 1 hour under room temperature(28 ℃),then pull out test was employed.Group C(reinforcement group): The bilateral FEPV track were directly filled with 3 to 5 ml of CPC.Then pull out test was employed again.Morphology of CPC around the FEPV was observed by section of the vertebrae along the FEPV.Group B: In the remaining 10 specimens,the FEPV were loaded in the superior-inferior direction with increasing forces of 25 to 200 N for 800 cycles.
Results: The pull out strength of the FEPV in control group was(843.1±132.2) N,whereas those following CPC restoration and CPC augmentation were(1 456.2±239.9) N and(1 499.5±241.2) N respectively.The pull out strength following CPC restoration and augmentation were significantly greater than that of control group(P<0.05).No CPC was found in vertebral canal or surface of pedicle in the FEPV.In cyclic bending resistance tests,augmented the FEPV was found to withstand a greater number of cycles or greater loading(200 N,800 cycles) before loosening.
Conclusion: Restoration and augmentation with CPC offered a significantly increase of strength for the FEPV fixation,and it can decrease spill in vertebral canal or surface of pedicle.Cells of bone were easily implanted into lateral hole of the FEPV without CPC.It can increase stability of the FEPV too,and can be used clinically in case of failure of pedicle screw fixation. |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 胡勇,谢辉,杨述华,徐荣明,章伟文,冯建翔,付德皓.椎弓根融合器添加磷酸钙骨水泥后的生物力学效果[J].中国骨伤,2007,20(2):103~105 |
| 英文格式: | HU Yong,,XIE Hui,YANG Shu-hua,XU Rong-ming,ZHANG Wei-wen,FENG Jian-xiang,FU De-hao.Augmentation of fusion equipment of pedicle of vertebrae with calcium phosphate cement:An in vitro biomechanical study[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(2):103~105 |
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