Department of Orthopaedic Surgery, Martini Hospital, Groningen, The Netherlands.
Spine (Phila Pa 1976). 2009 Aug 15;34(18):E640-4. doi: 10.1097/BRS.0b013e3181b1fed8.
Controlled in vitro study.
To compare two kyphoplasty techniques in cadaveric fractured vertebrae: an experimental vertebral jack tool (VJT) and an inflatable bone tamp (IBT).
A previous biomechanical study showed restored strength and stiffness after height restoration in cadaveric-fractured osteoporotic vertebrae using a new device for reduction of osteoporotic vertebral fractures.
Anterior wedge fractures (AO type A1.2) were created in 8 (4 lumbar, 4 thoracic) vertebrae by displacement eccentric external forces. In all vertebrae the amount of height reduction was 35%. After compression, 4 vertebrae were restored in height using the VJT procedure. Four vertebrae were restored in height using the IBT procedure. Posttreatment strength and stiffness of the vertebrae were determined by a compression test identical to the pretreatment compression protocol. RESULTS.: In the VJT group the post-restoration strength was 81% +/- 13% of the original strength and in the IBT group it was 96% +/- 32%. The post-restoration stiffness in the VJT group was 61% +/- 42% of the original stiffness and in the IBT group 76% +/- 62% of the original stiffness. The vertebrae in the VJT group were restored to 101% +/- 2% of their original height whereas this was 104% +/- 14% in the IBT group. In this study, no cases of cement leakage were found. No cases of damaging of the end plates, new fractures or perforations were seen in both groups. The mean amount of cement inserted for the VJT group was 3.6 +/- 0.9 cm and for the IBT group 5.9 +/- 0.8 cm.
Both kyphoplasty procedures were able to restore height in this in vitro study, while strength and stiffness were partially restored, with no significant differences. In this study on average significant less cement was used in the VJT procedure. No complications were noted in both groups. This new end plate-to-end plate laminar augmentation technique may be of clinical advantage.
对照体外研究。
比较两种经皮球囊扩张椎体后凸成形术技术在尸体骨折椎体中的疗效：一种是实验性椎体千斤顶工具（VJT），另一种是可膨胀骨压平器（IBT）。
先前的一项生物力学研究表明，在使用新的骨质疏松性椎体骨折复位设备恢复骨质疏松性骨折后，尸体骨折的椎体的强度和刚度得到了恢复。
通过偏心外部力的位移在 8 个（4 个腰椎，4 个胸椎）椎体中创建前楔形骨折（AO 型 A1.2）。所有椎体的高度降低均为 35%。压缩后，4 个椎体使用 VJT 程序恢复高度。4 个椎体使用 IBT 程序恢复高度。使用与预处理压缩方案相同的压缩试验确定椎体治疗后的强度和刚度。
在 VJT 组中，复位后强度为原始强度的 81% +/- 13%，而在 IBT 组中为 96% +/- 32%。VJT 组复位后刚度为原始刚度的 61% +/- 42%，而 IBT 组为原始刚度的 76% +/- 62%。VJT 组的椎体恢复到原始高度的 101% +/- 2%，而 IBT 组为 104% +/- 14%。在这项研究中，没有发现水泥渗漏的病例。在两组中均未发现终板损坏、新骨折或穿孔的病例。VJT 组的平均水泥插入量为 3.6 +/- 0.9 cm，而 IBT 组为 5.9 +/- 0.8 cm。
在这项体外研究中，两种后凸成形术均能够恢复椎体高度，而强度和刚度部分恢复，无明显差异。在这项研究中，VJT 手术中平均使用的水泥量显著减少。两组均无并发症。这种新的终板-终板层状增强技术可能具有临床优势。
