Graduate Institute of Medical Mechatronics, Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan.
BMC Musculoskelet Disord. 2012 Oct 16;13:198. doi: 10.1186/1471-2474-13-198.
Polymethylmethacrylate (PMMA) is commonly used for clinical applications. However, the short handling time increases the probability of a surgeon missing the crucial period in which the cement maintains its ideal viscosity for a successful injection. The aim of this article was to illustrate the effects a reduction in temperature would have on the cement handling time during percutaneous vertebroplasty.
The injectability of bone cement was assessed using a cement compressor. By twisting the compressor, the piston transmits its axial load to the plunger, which then pumps the bone cement out. The experiments were categorized based on the different types of hypothermic manipulation that were used. In group I (room temperature, sham group), the syringes were kept at 22°C after mixing the bone cement. In group 2 (precooling the bone cement and the container), the PMMA powder and liquid, as well as the beaker, spatula, and syringe, were stored in the refrigerator (4°C) overnight before mixing. In group 3 (ice bath cooling), the syringes were immediately submerged in ice water after mixing the bone cement at room temperature.
The average liquid time, paste time, and handling time were 5.1 ± 0.7, 3.4 ± 0.3, and 8.5 ± 0.8 min, respectively, for group 1; 9.4 ± 1.1, 5.8 ± 0.5, and 15.2 ± 1.2 min, respectively, for group 2; and 83.8 ± 5.2, 28.8 ± 6.9, and 112.5 ± 11.3 min, respectively, for group 3. The liquid and paste times could be increased through different cooling methods. In addition, the liquid time (i.e. waiting time) for ice bath cooling was longer than for that of the precooling method (p < 0.05).
Both precooling (i.e. lowering the initial temperature) and ice bath cooling (i.e. lowering the surrounding temperature) can effectively slow polymerization. Precooling is easy for clinical applications, while ice bath cooling might be more suitable for multiple-level vertebroplasty. Clinicians can take advantage of the improved injectability without any increased cost.
聚甲基丙烯酸甲酯（PMMA）常用于临床应用。然而，较短的操作时间增加了外科医生错过水泥保持理想粘度以成功注射的关键时期的可能性。本文旨在说明温度降低对经皮椎体成形术中骨水泥操作时间的影响。
使用骨水泥压缩机评估骨水泥的可注射性。通过旋转压缩机，活塞将其轴向载荷传递给柱塞，柱塞将骨水泥泵出。实验根据使用的不同低温操作类型进行分类。在第 1 组（室温，假手术组）中，混合骨水泥后将注射器保持在 22°C。在第 2 组（预冷却骨水泥和容器）中，PMMA 粉末和液体以及烧杯、刮刀和注射器在混合前整夜存放在冰箱（4°C）中。在第 3 组（冰浴冷却）中，混合室温下的骨水泥后，立即将注射器浸入冰水中。
第 1 组的平均液体时间、糊化时间和操作时间分别为 5.1±0.7、3.4±0.3 和 8.5±0.8 分钟；第 2 组分别为 9.4±1.1、5.8±0.5 和 15.2±1.2 分钟；第 3 组分别为 83.8±5.2、28.8±6.9 和 112.5±11.3 分钟。不同的冷却方法可以增加液体和糊化时间。此外，冰浴冷却的液体时间（即等待时间）比预冷法长（p<0.05）。
预冷（即降低初始温度）和冰浴冷却（即降低周围温度）都可以有效地减缓聚合。预冷便于临床应用，而冰浴冷却可能更适合多节段椎体成形术。临床医生可以在不增加成本的情况下利用改善的可注射性。
