可吸收球囊椎体成形术治疗胸腰椎爆裂骨折的实验研究Experimental study about absorbable balloon vertebroplasty for the treatment of thoracolumbar burst fracture
周云;唐天驷;章洪喜;杨惠林;熊成东;潘高峰;刘昌胜;王以进;
摘要(Abstract)：
[目的]探讨结合短节段椎弓根螺钉系统撑开复位内固定的可吸收球囊椎体成形术治疗胸腰椎爆裂骨折的生物力学性能变化。[方法]采集6具新鲜固定湿润成人尸体胸腰椎标本,制成T11~L1,L2~4、L1~3节段标本10个,用自由落体撞击试验造成中间椎体爆裂型骨折,行APF椎弓根螺钉撑开复位,经椎弓根于伤椎椎体内置入可吸收高分子材料—DL-乳酸与ε-己内酯(70:30)的共聚物(PDLLA-CL)制作的可吸收球囊,注入自固化磷酸钙骨水泥行可吸收球囊椎体成形术。分别于骨折前、骨折撑开复位椎体成形术后,用万能材料试验机测定中间椎体在前屈、后伸、侧屈状态下应力—应变、轴向刚度变化及扭转应力下刚度的变化。[结果]伤椎经可吸收球囊椎体成形术治疗后,抗压强度均有所增加,前屈为8%,后伸15%,侧屈9.8%,其中以后伸时增加显著(P<0.05)。治疗后的轴向刚度普遍得到提高,与骨折前相比,前屈增加11%,后伸增加8%,侧屈增加3%。治疗后椎体在扭转应力下刚度小于骨折前,但两者差异不明显(P>0.05)。[结论](1)结合短节段椎弓根螺钉系统撑开复位内固定的可吸收球囊椎体成形术,有助于伤椎的重建,术后脊柱的生物力学特性接近骨折前水平;(2)可吸收球囊椎体成形术治疗胸腰椎爆裂骨折,在避免骨水泥渗漏可能导致的潜在危险之前提下,从本质上恢复胸腰椎爆裂型骨折伤椎椎体结构的完整性,恢复其高度,从而恢复和维持脊柱的生理弧度,防止继发性脊柱后凸畸形变引起的迟发性腰背痛及脊髓、神经损伤,以从根本上解决单纯用经椎弓根内固定器治疗胸腰椎爆裂型骨折遗留的并发症,为临床治疗胸腰椎爆裂骨折提供了一个新的方法。
关键词(KeyWords)： 可吸收球囊;胸腰椎爆裂骨折;椎体成形术;生物力学
基金项目(Foundation):
作者(Author): 周云;唐天驷;章洪喜;杨惠林;熊成东;潘高峰;刘昌胜;王以进;
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DOI:
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