Zheng Zhaomin, Luk Keith D K, Kuang Guanming, Li Zhaoyang, Lin Jerry, Lam Wing M, Cheung Kenneth M C, Lu William W
Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, China.
Spine (Phila Pa 1976). 2007 Sep 1;32(19):2076-82. doi: 10.1097/BRS.0b013e3181453f64.
Evaluation of a novel, leakage-free vertebroplastic instrumentation by fresh cadaveric studies.
To compare Vessel-X, a novel percutaneous bone void filling container system, with conventional kyphoplasty in restoring strength, stiffness, and height in experimentally induced vertebral compressive fractures and morphologically determine the cement distribution.
Clinically, both vertebroplasty and kyphoplasty perform well in reinforcement and pain relief. One of the shortcomings, however, is the risk of cement leakage. Vessel-X is a novel bone expander and bone void filler combined instrumentation for vertebral augmentation requiring evaluation.
A total of 28 fresh-frozen vertebral specimens were randomly assigned to 4 groups for testing: unipedicular kyphoplasty, bipedicular kyphoplasty, unipedicular Vessel-X, and bipedicular Vessel-X. Compressive fractures were experimentally created on each vertebra after determining the bone mineral density. Kyphoplasty and Vessel-X were performed using bioactive bone cement (SrHAC) under C-arm fluoroscopy and compared by compression testing to measure the effects of augmentation. Morphologic observations were also performed to determine the cement distribution and vertebral height restoration.
There was no significant difference in bone mineral density, initial strength, and stiffness in any of the groups. Furthermore, no significant difference was observed in total cement volume in intragroup comparison within the unipedicular or bipedicular groups. Vessel-X bone filler container could expand well and contain most of the cement. The height restoration ranged from 88.5% to 96.4% in all groups. The augmented strength with unipedicular and bipedicular injections reached 3651.57 N and 4833.73 N, respectively. Stiffness with bipedicular injection was significantly higher than that of unipedicular injection.
Vessel-X was comparable to kyphoplasty in restoring the mechanical properties and height of the fractured vertebrae. Interestingly, Vessel-X instrumentation showed considerably less cement leakage and better cement placement in the vertebral body. Therefore, it could be a leakage controllable technique in percutaneous vertebral augmentation.
通过新鲜尸体研究评估一种新型无渗漏椎体成形器械。
将新型经皮骨缺损填充容器系统Vessel-X与传统椎体后凸成形术在恢复实验性诱导的椎体压缩性骨折的强度、刚度和高度方面进行比较，并从形态学上确定骨水泥分布情况。
临床上，椎体成形术和椎体后凸成形术在强化和缓解疼痛方面均表现良好。然而，缺点之一是骨水泥渗漏风险。Vessel-X是一种新型的用于椎体强化的骨扩张器和骨缺损填充联合器械，需要进行评估。
总共28个新鲜冷冻椎体标本随机分为4组进行测试：单侧椎体后凸成形术、双侧椎体后凸成形术、单侧Vessel-X和双侧Vessel-X。在测定骨密度后，在每个椎体上实验性制造压缩性骨折。在C形臂荧光透视引导下，使用生物活性骨水泥（SrHAC）进行椎体后凸成形术和Vessel-X操作，并通过压缩测试进行比较以测量强化效果。还进行了形态学观察以确定骨水泥分布和椎体高度恢复情况。
任何一组的骨密度、初始强度和刚度均无显著差异。此外，在单侧或双侧组内的组内比较中，骨水泥总体积也未观察到显著差异。Vessel-X骨填充容器能良好扩张并容纳大部分骨水泥。所有组的高度恢复范围为88.5%至96.4%。单侧和双侧注射后的强化强度分别达到3651.57 N和4833.73 N。双侧注射的刚度显著高于单侧注射。
Vessel-X在恢复骨折椎体的力学性能和高度方面与椎体后凸成形术相当。有趣的是，Vessel-X器械显示骨水泥渗漏明显更少，且在椎体内的骨水泥放置更好。因此，它可能是经皮椎体强化中一种可控制渗漏的技术。
