Zhan Yi, Bao Chang, Yang Huiming, Li Liang, Yan Liang, Kong Lingbo, Hao Dingjun, Wang Biao
Spine Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, China.
The Second Clinical Medical College of Shaanxi University of Chinese Medicine, Xi'an, Shaanxi, China.
Front Bioeng Biotechnol. 2023 May 18;11:1077192. doi: 10.3389/fbioe.2023.1077192. eCollection 2023.
Kummell's Disease (KD) was originally proposed by Dr. Hermann Kummell in 1891 as a type of delayed posttraumatic vertebral collapse, which is a clinical phenomenon. The purpose of this experiment is to compare the strength of bone cement and the novel bone cement bridging screw in the treatment of thoracolumbar Kummell disease (KD) with other treatment methods. Thirty sheep spine specimens were selected. T12 to L2 segments were selected, and a KD intravertebral vacuum cleft model was made at the L1 segment. According to the ways of cement filling, the specimens were divided into percutaneous vertebroplasty (PVP), PVP combined with unilateral percutaneous pediculoplasty (PPP), PVP combined with bilateral PPP, unilateral novel bone cement bridging screw system combined with PVP, and bilateral cement bridging screw system combined with PVP groups. There were two experiments: three-dimensional biomechanical strength test and axial compression test. In the three-dimensional biomechanical strength test, we measured the strength of bone cement in specimens under six motion states, including flexion, extension, left bending, right bending, and left and right axial rotations. In the axial compression test, we detected the maximum axial pressure that the bone cement could withstand when it was under pressure until the bone cement was displaced. The unilateral or bilateral novel bone cement bridging screw with PVP groups had the best strength under flexion, extension, left bending, right bending, and had better biomechanical strength, with a significant difference from the other three groups ( < 0.05). There was no significant difference between the unilateral or bilateral novel bone cement bridging screw with PVP groups ( > 0.05). Unilateral and bilateral novel bone cement bridging screw could achieve similar bone cement strength. Compared with the other three groups, the unilateral or bilateral novel bone cement bridging screw with PVP groups are higher 136.35%, 152.43%; 41.93%, 51.58%; 34.37%, 43.50% respectively. The bilateral novel bone cement bridging screw with PVP could bear the largest pressure under vertical force. To conclude, the novel bone cement bridging screw can increase the strength of bone cement and avoid the loosening and displacement of bone cement in the treatment of KD of the thoracolumbar spine.
库默尔病（KD）最初由赫尔曼·库默尔博士于1891年提出，是一种创伤后延迟性椎体塌陷的类型，属于一种临床现象。本实验的目的是比较骨水泥和新型骨水泥桥接螺钉在治疗胸腰椎库默尔病（KD）时与其他治疗方法的强度。选取了30个羊脊柱标本。选取T12至L2节段，在L1节段制作KD椎体内真空裂隙模型。根据骨水泥填充方式，将标本分为经皮椎体成形术（PVP）组、PVP联合单侧经皮椎弓根成形术（PPP）组、PVP联合双侧PPP组、单侧新型骨水泥桥接螺钉系统联合PVP组以及双侧骨水泥桥接螺钉系统联合PVP组。进行了两项实验：三维生物力学强度测试和轴向压缩测试。在三维生物力学强度测试中，我们测量了标本在六种运动状态下骨水泥的强度，包括前屈、后伸、左侧弯曲、右侧弯曲以及左右轴向旋转。在轴向压缩测试中，我们检测了骨水泥在受压直至移位时所能承受的最大轴向压力。单侧或双侧新型骨水泥桥接螺钉联合PVP组在前屈、后伸、左侧弯曲、右侧弯曲时具有最佳强度，且生物力学强度更好，与其他三组有显著差异（<0.05）。单侧或双侧新型骨水泥桥接螺钉联合PVP组之间无显著差异（>0.05）。单侧和双侧新型骨水泥桥接螺钉可实现相似的骨水泥强度。与其他三组相比，单侧或双侧新型骨水泥桥接螺钉联合PVP组分别高出136.35%、152.43%；41.93%、51.58%；34.37%、43.50%。双侧新型骨水泥桥接螺钉联合PVP在垂直力作用下能承受最大压力。总之，新型骨水泥桥接螺钉在治疗胸腰椎KD时可提高骨水泥强度，避免骨水泥松动和移位。
