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改良PVP与传统PKP治疗椎体周壁损伤型OVCF的生物力学对比研究

Comparative study on the biomechanics between improved PVP and traditional PKP in the treatment of vertebral peripheral wall damage-type OVCF.

作者信息

Zhou Tao, Lin Hao, Wang Hongliang, Chen Xiaoqiang, He Fang

机构信息

Department of Orthopaedics, The People's Hospital of Maanshan, Maanshan, Anhui 243000, P.R. China.

Clinical College of Maanshan, Anhui Medical University, Maanshan, Anhui 243000, P.R. China.

出版信息

Exp Ther Med. 2017 Jul;14(1):575-580. doi: 10.3892/etm.2017.4542. Epub 2017 Jun 1.

Abstract

We compared the biomechanics between improved percutaneous vertebroplasty (improved PVP) and traditional percutaneous kyphoplasty (PKP) in the treatment of vertebral peripheral wall damage-type osteoporotic vertebral compression fracture (OVCF). A total of 15 vertebral peripheral wall damage-type OVCF models of new calves (12-14 weeks) were treated with a decalcifying agent (Shandon TBD-1) with the vertebral compression fracture. The vertebral volume and anterior height before modeling, and the vertebral BMD before and after modeling were measured. The models were randomly divided into three groups: the improved PVP group (Group A), the traditional PKP group (Group B) and the control group (Group C). BMD of Groups A, B and C after decalcification was significantly lower than that before decalcification (P<0.05). There were no significant differences in BMD before and after decalcification among Groups A, B and C (P>0.05). There was no significant difference in the initial strength and stiffness among the three groups (P>0.05). The postoperative strength of Groups A and B was 1.036±300 and 1.045±200 N, respectively, which was significantly higher than the initial strength (P<0.05). The postoperative stiffness of Groups A and B was 395±250 and 470±270 N/mm, respectively, which was slightly lower than the initial stiffness, however, the differences were not statistically significant (P>0.05). In the comparison of postoperative strength and stiffness between Groups A and B, the postoperative strength in Group A was lower than that in Group B; differences were not statistically significant (P>0.05); there was no significant difference in the postoperative stiffness between Groups A and B (P>0.05). There were no significant differences of injection of bone cement between the two groups (P>0.05). Therefore, an improved PVP can basically realize the curative effects of traditional PKP in the treatment of vertebral peripheral wall damage-type OVCF, which can be used as clinical reference.

摘要

我们比较了改良经皮椎体成形术(改良PVP)与传统经皮椎体后凸成形术(PKP)在治疗椎体周壁损伤型骨质疏松性椎体压缩骨折(OVCF)中的生物力学差异。选取15只新出生12 - 14周小牛的椎体周壁损伤型OVCF模型,采用脱钙剂(Shandon TBD - 1)处理椎体压缩骨折。测量建模前椎体体积和前缘高度,以及建模前后椎体骨密度。将模型随机分为三组:改良PVP组(A组)、传统PKP组(B组)和对照组(C组)。脱钙后A、B、C组骨密度均显著低于脱钙前(P<0.05)。A、B、C组脱钙前后骨密度差异无统计学意义(P>0.05)。三组初始强度和刚度差异无统计学意义(P>0.05)。A组和B组术后强度分别为1.036±300 N和1.045±200 N,显著高于初始强度(P<0.05)。A组和B组术后刚度分别为395±250 N/mm和470±270 N/mm,略低于初始刚度,但差异无统计学意义(P>0.05)。A组与B组术后强度和刚度比较,A组术后强度低于B组,差异无统计学意义(P>0.05);A组与B组术后刚度差异无统计学意义(P>0.05)。两组骨水泥注入量差异无统计学意义(P>0.05)。因此,改良PVP在治疗椎体周壁损伤型OVCF时基本能实现传统PKP的疗效,可供临床参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d49e/5488447/06f316d70b29/etm-14-01-0575-g00.jpg

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