经皮椎体成形及后凸成形椎体注入材料的生物力学分析

Biomechanical analysis on the materials for the percutaneous vertebroplasty and percutaneous kyphoplasty

背景:经皮椎体成形与后凸成形是脊柱外科近来发展的一项新型微创外科技术,通过经皮向压缩骨折椎体内直接注入或者先通过球囊扩张再注入骨水泥等填充物,从而增强病变椎体的力学稳定性,其治疗效果满意且并发症少,但成形后脊柱生物力学的研究也发现了一些问题。目的:探讨经皮椎体成形与后凸成形后填充材料的效应及生物力学分析。方法:应用计算机检索CNKI和PubMed数据库中1999-01/2012-08关于经皮椎体成形术/经皮椎体后凸成形术填充材料及治疗后生物力学的文章,在标题和摘要中以"经皮椎体成形术;经皮椎体后凸成形术;聚甲基丙烯酸甲酯;骨水泥;玻璃陶瓷;生物力学;生物相容性;并发症"或"percutaneous vertebroplasty,percutaneous kyphoplasty;PMMA;cement;biomechanics;Biocompatibility;treatment"为检索词进行检索。选择文章内容与经皮椎体成形术/经皮椎体后凸成形术填充材料有关者,同一领域文献则选择近期发表或发表在权威杂志文章。初检得到132篇文献,根据纳入标准选择19篇文献进行分析。结果与结论:椎体成形的目的为最大程度上的恢复压缩椎体的刚度和抗压强度。不同的充填材料对椎体生物力学性质的影响也有不同。填充材料的发展可以有效增强骨折椎体的抗压能力和维持良好的形态学特征,并可能使骨折椎体的生物力学性质恢复到最佳的状态。

BACKGROUND： Percutaneous vertebroplasty and kyphoplasty are recently developed new minimally invasive surgical techniques in spinal surgery, can enhance the mechanical stability of the vertebra with less complications and satisfactory results by injecting the bone cement into the vertebral body via percutaneous directly or balloon dilatation. However, the research on the biomechanical of spinal also showed some problems after angioplasty. OBJECTIVE： To explore the effect of the material on percutaneous vertebroplasty and percutaneous kyphoplasty and biomechanical analysis. METHODS： A computer-based research was performed on CNKI database and PubMed database from January 1999 to August 2012 for the articles on the materials for percutaneous vertebroplasty/percutaneous kyphoplasty and the articles on the biomechanics after treatment. The key words of ＂percutaneous vertebroplasty, rcutaneous kyphoplasty, polymethyl methacrylate, cement, glass ceramic, biomechanics, biocompatibility, complication＂ in Chinese and ＂percutaneous vertebroplasty, percutaneous kyphoplasty, PMMA, cement, biomechanics, Biocompatibility, treatment＂ in English were put into the title and the abstract. The articles on the materials for percutaneous vertebroplasty/percutaneous kyphoplasty were selected, and for the articles in the same field, those published recently or in the authorized journals were preferred. A total of 132 articles were obtained after initial search, and 19 articles were included for review according the inclusion criteria. RESULTS AND CONCLUSION： The purpose of the vertebroplasty is to recover the stiffness and compressive strength of the compressed vertebral. Different materials have different impacts on the properties of the vertebral biomechanics. Development of the material can effectively enhance the vertebral compression capability and maintain the good morphological characteristics; it can also recover the vertebral biomechanical properties to the best state.