Yimin Yang, Zhi Zhang, ZhiWei Ren, Wei Ma, Jha Rajiv Kumar
Department of Orthopedics, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (mainland).
Department of Medical Research, Xi'an Medical College, Xi'an, China (mainland).
Med Sci Monit Basic Res. 2014 May 28;20:76-81. doi: 10.12659/MSMBR.890835.
The aim of this study was to evaluate the feasibility of treating vertebral compression fractures using an autonomously developed nitinol memory alloy vertebral stent.
Thoracolumbar vertebral specimens from adult human cadavers were made into models of compression fractures. The models were divided into group A, which received percutaneous kyphoplasty (PKP), balloon dilation, and nitinol memory alloy vertebral stent implantation (PKP + nitinol stent group); group B, which received percutaneous vertebroplasty (PVP) and direct implantation of a nitinol memory alloy vertebral stent (PVP + nitinol stent group); and group C, which received PKP, balloon dilation, and bone cement vertebroplasty (PKP + polymethylmethacrylate (PMMA) group). Vertebral heights were measured before and after the surgery and the water bath incubation to compare the impact of the 3 different surgical approaches on reducing vertebral compression.
The 3 surgical groups could all significantly restore the heights of compressed vertebral bodies. The vertebral heights of the PKP + nitinol stent group, PVP + nitinol stent group, and PKP + PMMA group were changed from the preoperative levels of (1.59±0.08) cm, (1.68±0.08) cm, and (1.66±0.11) cm to the postoperative levels of (2.00±0.09) cm, (1.87±0.04) cm, and (1.99±0.09) cm, respectively. After the water bath, the vertebral heights of each group were changed to (2.10±0.07) cm, (1.98±0.09) cm, and (2.00±0.10) cm, respectively. Pairwise comparison of the differences between the preoperative and postoperative vertebral heights showed that group A and group B differed significantly (P=0.000); group B and group C differed significantly (P=0.003); and group A and group C had no significant difference (P=0.172). Pairwise comparison of the differences in the vertebral heights before and after the water bath showed that group A and group C differed significantly (P=0.000); group B and group C differed significantly (P=0.000); and group A and group B had no significant difference (P=0.157).
The nitinol memory alloy stents can effectively support and reduce the compression of vertebral endplates and can be used to treat vertebral compression fractures without neurological symptoms.
本研究旨在评估自主研发的镍钛记忆合金椎体支架治疗椎体压缩骨折的可行性。
将成人尸体的胸腰椎椎体标本制成压缩骨折模型。模型分为A组,接受经皮椎体后凸成形术(PKP)、球囊扩张及镍钛记忆合金椎体支架植入(PKP+镍钛支架组);B组,接受经皮椎体成形术(PVP)及直接植入镍钛记忆合金椎体支架(PVP+镍钛支架组);C组,接受PKP、球囊扩张及骨水泥椎体成形术(PKP+聚甲基丙烯酸甲酯(PMMA)组)。在手术前后及水浴孵育后测量椎体高度,以比较3种不同手术方式对减轻椎体压缩的影响。
3个手术组均能显著恢复压缩椎体的高度。PKP+镍钛支架组、PVP+镍钛支架组和PKP+PMMA组的椎体高度从术前的(1.59±0.08)cm、(1.68±0.08)cm和(1.66±0.11)cm分别变为术后的(2.00±0.09)cm、(1.87±0.04)cm和(1.99±0.09)cm。水浴后,每组的椎体高度分别变为(2.10±0.07)cm、(1.98±0.09)cm和(2.00±0.10)cm。对术前和术后椎体高度差异进行两两比较,结果显示A组和B组差异有统计学意义(P=0.000);B组和C组差异有统计学意义(P=0.003);A组和C组差异无统计学意义(P=0.172)。对水浴前后椎体高度差异进行两两比较,结果显示A组和C组差异有统计学意义(P=0.000);B组和C组差异有统计学意义(P=0.000);A组和B组差异无统计学意义(P=0.157)。
镍钛记忆合金支架可有效支撑并减轻椎体终板的压缩,可用于治疗无神经症状的椎体压缩骨折。