Department of Spine Surgery, Dillingen Wertingen Hospitals, Ebersberg 36, 86637, Wertingen, Germany.
Skeletal Radiol. 2013 Jan;42(1):79-84. doi: 10.1007/s00256-012-1450-1. Epub 2012 Jun 9.
Intravertebral pressure (IP) is considered a possible factor influencing cement leakage in vertebroplasty (VP). Reports of measuring IP during the injection of the cement reveal rather low values in the periphery of the vertebral body but fail to determine the situation in the center. Hypothesizing there is a significant IP gradient between both areas intravertebral pressure measurements were conducted in a comparative biomechanical study.
VP was performed in ten lumbar cadaveric spines. A pressure sensor was either placed in the center or in the periphery of the vertebral body, while bone cement was delivered in 1.5-cc increments. Volume flow, cement mixing time, and room temperature were standardized and kept constant during cement injection.
During the administration of the first 1.5 cc of bone cement, the central IP (C-IP) increased to 23.6 kPa and the peripheral IP (P-IP) to 0.9 kPa on average. With the second injection, the mean C-IP was 42.8 kPa while the mean P-IP was 3.8 kPa. During the 3rd filling, C-IP averaged 69.9 kPa and P-IP 12.8 kPa, respectively. At the last increment, C-IP was at 70.7 kPa and P-IP at 24.5 kPa on average.
A centroperipheral IP gradient (∆IP) was monitored during cement delivery in VP. ∆IP decreases with increasing bone cement charge of the vertebra, but C-IP stays significantly higher than P-IP at all times. C-IP was consistently higher than IP values reported for VP so far.
椎体内压（IP）被认为是影响椎体成形术（VP）中水泥渗漏的一个可能因素。在注射水泥过程中测量 IP 的报告显示，椎体周围的 IP 值相当低，但未能确定中心的情况。假设在这两个区域之间存在显著的 IP 梯度，因此在一项比较生物力学研究中进行了椎体内压测量。
在十个腰椎尸体标本中进行 VP。压力传感器分别放置在椎体的中心或周围，同时以 1.5cc 的增量输送骨水泥。在注射水泥过程中，体积流量、水泥混合时间和室温标准化并保持恒定。
在注射第一支 1.5cc 骨水泥时，中央 IP（C-IP）平均增加到 23.6kPa，周围 IP（P-IP）增加到 0.9kPa。第二次注射时，平均 C-IP 为 42.8kPa，平均 P-IP 为 3.8kPa。在第三次填充时，C-IP 平均为 69.9kPa，P-IP 为 12.8kPa。在最后一次增量时，C-IP 平均为 70.7kPa，P-IP 平均为 24.5kPa。
在 VP 中输送水泥期间监测到中央到周围的 IP 梯度（∆IP）。∆IP 随椎体骨水泥负荷的增加而降低，但 C-IP 在任何时候都明显高于 P-IP。C-IP 始终高于迄今为止报告的 VP 中的 IP 值。
