球囊扩张椎体成形术治疗椎体压缩骨折的生物力学实验研究

The biomechanical effects of percutaneous kyphoplasty for treating vertebral compression fractures

目的评价球囊扩张椎体成形术对椎体压缩骨折椎体的生物力学性能。方法采用10只实验猪制备40例椎体压缩骨折标本,按照简单数字表法将标本分为研究组和对照组各20例,研究组行球囊扩张椎体成形术,对照组采用生理盐水纱布包裹,比较两组标本的生物力学性能。结果治疗后研究组椎体前后左右高度与原始椎体相比无显著差异(P>0.05),但显著高于对照组椎体(P<0.05);治疗后研究组椎体刚度显著高于对照组(P<0.05),最大载荷显著低于对照组(P<0.05);在固定载荷500N下,研究组椎间盘位移值显著低于对照组(t=4.026,P=0.006);研究组椎间盘500N载荷下应变值、椎间盘应力值较对照组显著升高(P<0.05)。结论经球囊扩张椎体成形术治疗椎体压缩骨折,椎体最大载荷和刚度的恢复状况好,可达到止痛和预防椎体再次骨折的效果,具有临床应用价值。

Objective To evaluate the biomechanical effects of percutaneous kyphoplasty. Methods 40 vertebral compression fracture specimens of 10 pigs were divided into study group and control group. The study group underwent balloon dilatation of vertebral plasty. The control group was treated with physiological saline gauze wrapped. The biome- chanical properties were observed. Results There was no significant difference in the height of left and right vertebrae be- tween the study group and the original vertebral body （P〉0. 05）. The height of left and right vertebrae of study group were significantly higher than that of the control group （P〈0.05）. The vertebral rigidity of the study group was signifi- cantly higher than that of the control group （P〈0.05）, and the maximum load was significantly lower than the control group （P〈0. 05） ; The mean disc displacement was （2.11 ± 0.14） mm in the study group （3.21±0.12） mm （t=4. 026, P=0. 006） at fixed loading of 500N. The strain value （1926 ± 46） με and the intervertebral disc stress （1.05±0. 08MPa） in the study group were significantly higher than those in the control group （（1800 ± 42） με, （0.90 ±0. 05） MPa, P〈0.05）. Conclusion Percutaneous kyphoplasty can achieve good recovery of the maximum load and stiffness of vertebra and pain relief and prevent vertebral fractures again for vertebral compression fractures.