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一种新型单侧经皮椎体后凸成形术可实现有效的生物力学强度并减少辐射暴露。

A novel technique of unilateral percutaneous kyphoplasty achieves effective biomechanical strength and reduces radiation exposure.

作者信息

Zhuang Yan, Yang Lei, Li Haijun, Ren Yajun, Cao Xiaojian

机构信息

Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, China; Department of Orthopedics, The Affiliated Jiangyin Hospital of Southeast University Medical CollegeWuxi, China.

Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University Nanjing, China.

出版信息

Am J Transl Res. 2016 Feb 15;8(2):1172-9. eCollection 2016.

Abstract

PURPOSE

To develop a novel technique of percutaneous kyphoplasty (PKP) with effective biomechanical strength and lower radiation exposure.

METHODS

Thirty fresh lumbar vertebrae isolated from six hogs were decalcified and compressed to induce osteoporotic vertebral compression fractures. Kyphoplasty was performed using three different techniques (ten for each group): conventional unilateral approach (group A), conventional bilateral approach (group B) and novel unilateral approach (group C). Biomechanical indexes including Yield load and stiffness were tested before and after kyphoplasty. The anterior height of each vertebral body (AHVB) was measured before compression, after compression and after kyphoplasty. Frequency of C-arm use and volume of bone cement were also recorded in the process.

RESULTS

Compared with group A, our novel technique in group C can significantly improve the recovery of AHVB after compression fractures. However, there was no statistical difference between group B and group C. Values of Yield load in both group B and group C were statistically higher than that in group A, however, no significant difference was found between group B and C. Statistical results of stiffness were similar to Yield load. Regarding volume of bone cement and radiation exposure, the novel technique in group C needed more bone cement and fluoroscopy use than in group A but less than in group B.

CONCLUSIONS

This novel device makes unilateral kyphoplasty feasible, safe and effective. In the premise of guaranteed biomechanical strength, the new technique significantly reduces risk of radiation exposure in kyphoplasty.

摘要

目的

开发一种具有有效生物力学强度且辐射暴露较低的经皮椎体后凸成形术(PKP)新技术。

方法

从六头猪身上分离出30个新鲜腰椎椎体,进行脱钙并压缩以诱导骨质疏松性椎体压缩骨折。采用三种不同技术进行椎体后凸成形术(每组10个):传统单侧入路(A组)、传统双侧入路(B组)和新型单侧入路(C组)。在椎体后凸成形术前和术后测试包括屈服载荷和刚度在内的生物力学指标。测量每个椎体在压缩前、压缩后和椎体后凸成形术后的前高度。在此过程中还记录了C形臂的使用频率和骨水泥用量。

结果

与A组相比,我们C组的新技术可显著提高压缩骨折后椎体前高度的恢复情况。然而,B组和C组之间无统计学差异。B组和C组的屈服载荷值在统计学上均高于A组,但B组和C组之间未发现显著差异。刚度的统计结果与屈服载荷相似。关于骨水泥用量和辐射暴露,C组的新技术比A组需要更多的骨水泥且使用荧光透视更多,但比B组少。

结论

这种新型装置使单侧椎体后凸成形术可行、安全且有效。在保证生物力学强度的前提下,新技术显著降低了椎体后凸成形术中辐射暴露的风险。

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