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一种新型骨水泥桥接螺钉系统与传统治疗方法治疗 Kummell 病的生物力学研究。

A biomechanical investigation comparing a novel bone cement bridging screw system with conventional treatment methods for Kummell's disease.

机构信息

Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.

Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.

出版信息

Sci Rep. 2024 Oct 26;14(1):25545. doi: 10.1038/s41598-024-77511-6.

Abstract

Based on the characteristics of Kummell's disease (KD) and related anatomical structures of the thoracolumbar spine, a novel bone cement screw system has been designed to effectively avoid the cement loosening and displacement. This experiment aimed to assess the biological effects of the novel bone cement screw system in KD on fresh cadaveric thoracolumbar spine specimens, thereby discussing its potential application value and providing a foundation for clinical implementation. This study employed a total of 50 fresh female adult cadaver specimens. Each specimen underwent extraction of the T12 to L2 segment followed by the creation of an artificial KD model at the L1 segment and subsequent establishment of five distinct types of bone cement repair models. Model A represents the percutaneous vertebroplasty (PVP) model, Model B combines PVP with unilateral percutaneous pediculoplasty (PPP), Model C combines PVP with bilateral PPP, Model D introduces the novel bone cement screw combined with unilateral PVP, and Model E combines the novel screw with bilateral PVP, each group consists of 10 specimens. Subsequently, the six-axis spine robot was employed to execute cement three-dimensional biomechanical strength tests in six directions, including anterior flexion and posterior extension, left and right lateral bending, as well as left and right rotation. The novel bone cement screw, whether used unilaterally or bilaterally in combination with the PVP model, exhibits significantly reduced bone cement mobility and superior biomechanical stability during anterior flexion, posterior extension, left lateral bending, and right lateral bending (P<0.05).No significant differences were observed among the five models under both left and right rotation (P > 0.05).When comparing the novel bone cement screw combined with PVP unilaterally and bilaterally, no statistically significant difference was observed in the stability of bone cement across all six directions of motion (P>0.05). To conclude, this novel bone cement bridging screw system exhibits superior biomechanical stability compared to commonly used treatments. Furthermore, both unilateral and bilateral implementations of the novel bone cement screw system yield without significant differences observed. These findings present a reliable and innovative approach for clinical management of KD.

摘要

基于 Kummell 病(KD)的特点和胸腰椎相关解剖结构,设计了一种新型骨水泥螺钉系统,可有效避免骨水泥松动和移位。本实验旨在评估新型骨水泥螺钉系统在 KD 中的生物力学效果,为临床应用提供理论依据。本研究共使用了 50 具新鲜女性成人尸体标本。每个标本均取自 T12 至 L2 节段,然后在 L1 节段制作人工 KD 模型,再建立 5 种不同类型的骨水泥修复模型。模型 A 为经皮椎体成形术(PVP)模型,模型 B 为 PVP 联合单侧经皮椎弓根成形术(PPP),模型 C 为 PVP 联合双侧 PPP,模型 D 为新型骨水泥螺钉联合单侧 PVP,模型 E 为新型螺钉联合双侧 PVP,每组 10 例。随后,使用六轴脊柱机器人在六个方向(前屈和后伸、左右侧弯和左右旋转)进行水泥三维生物力学强度测试。新型骨水泥螺钉无论单侧还是双侧联合 PVP 模型,在前屈、后伸、左侧弯和右侧弯时,骨水泥活动度明显降低,生物力学稳定性更高(P<0.05)。而在左右旋转时,五个模型之间没有显著差异(P > 0.05)。新型骨水泥螺钉联合单侧和双侧 PVP 时,在六个运动方向的骨水泥稳定性方面,差异无统计学意义(P>0.05)。综上所述,与传统治疗方法相比,新型骨水泥桥接螺钉系统具有更好的生物力学稳定性,单侧和双侧应用均能取得良好的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6177/11513101/2f4536946e13/41598_2024_77511_Fig1_HTML.jpg

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