Baroud Gamal, Martin Pierre-Luc, Cabana François
Laboratoire de biomécanique, Génie mécanique, Université de Sherbrooke, Québec, Canada.
Spine (Phila Pa 1976). 2006 Jan 1;31(1):115-9. doi: 10.1097/01.brs.0000192722.30052.a4.
An experimental study using cadaveric vertebrae.
To measure the injection pressure in an ex vivo model and determine whether the redesigned cannula, featuring 2 distinct sections of different diameters, significantly reduces the injection pressure.
An important limitation of vertebroplasty is the excessive pressure required to inject sufficient cement. The redesigned cannula accounts for the "bottleneck" of the injection previously identified. It has a distal section that is adapted to the pedicles and a proximal section with a larger diameter.
Two cannulas were tested, a conventional 8-gauge and the redesigned cannula. There were 3 mL of cement injected in small strokes of 0.75 mL into the left and right hemivertebrae. A custom-made injection device monitored the injection pressure and cement volume.
Average injection pressure was 2.3 MPa, often approaching the human physical limit and resulting in insufficient filling. The average pressure of the redesigned cannula was 44% lower than that of the conventional cannula, a highly significant result (P < 0.001).
The new cannula may improve vertebroplasty by significantly easing cement injection. It is cost effective and can be easily integrated into the existing procedure.
一项使用尸体椎骨的实验性研究。
在体外模型中测量注射压力,并确定重新设计的具有两个不同直径区段的套管是否能显著降低注射压力。
椎体成形术的一个重要局限性是注入足够骨水泥所需的压力过大。重新设计的套管解决了先前确定的注射“瓶颈”问题。它有一个适合椎弓根的远端部分和一个直径较大的近端部分。
测试了两种套管,一种是传统的8号套管,另一种是重新设计的套管。以0.75 mL的小剂量分多次向左右半椎体注入3 mL骨水泥。一个定制的注射装置监测注射压力和骨水泥体积。
平均注射压力为2.3 MPa,常常接近人体体能极限,导致填充不足。重新设计的套管的平均压力比传统套管低44%,这是一个非常显著的结果(P < 0.001)。
新套管可能通过显著减轻骨水泥注射难度来改善椎体成形术。它具有成本效益,并且可以很容易地整合到现有手术中。