CPC填充物的生物力学特征及用于创伤性胸腰椎骨折患者PKP术中对腰椎功能的影响

Biomechanical Characteristics of CPC Fillers and the Effect on Lumbar Function during PKP in Patients with Traumatic Thoracolumbar Fracture

【目的】探讨磷酸钙骨水泥(CPC)填充物的生物力学特征及用于创伤性胸腰椎骨折患者经皮椎体后凸成形术(PKP)术中对腰椎功能的影响。【方法】选取2019年4月至2021年4月本院收治的100例创伤性胸腰椎骨折患者,按手术方式不同分为观察组和对照组,每组50例。观察组采用PKP联合CPC填充治疗,对照组采用PKP联合聚甲基丙烯酸甲酯骨水泥(PMMA)填充治疗,比较两组材料的生物力学特征;比较两组患者手术时间、术中出血量、卧床时间、住院时间,术后疗效、并发症,术前及术后6个月伤椎椎体高度、视觉模拟评分法(visual analogue scale,VAS)评分、Cobb角、Oswestry功能障碍指数(ODI)评分等。【结果】观察组的CPC抗弯强度、断裂功、弹性模量均优于对照组的PMMA(P<0.05);两组总有效率比较,差异无统计学意义(P>0.05);两组手术时间、术中出血量、卧床时间、住院时间比较,差异无统计学意义(P>0.05)。两组术前、术后6个月伤椎椎体中部高度、前缘高度、后缘高度比较,差异无统计学意义(P>0.05);两组术后6个月伤椎椎体前缘高度、中部高度、后缘高度均明显高于术前(P<0.05)。两组术前、术后6个月VAS评分、Cobb角、ODI评分比较,差异无统计学意义(P>0.05);两组术后6个月VAS评分、Cobb角、ODI评分均少于术前(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。【结论】PKP术中分别采用CPC及PMMA填充治疗创伤性胸腰椎骨折患者,两种治疗方法均有较高的治疗有效率,可改善腰椎功能,但CPC具有更高的生物力学性能,更符合骨科填充材料的生物学活性要求。

【Objective】To investigate the biomechanical characteristics of calcium phosphate bone cement(CPC)filler and its effect on lumbar function during percutaneous kyphoplasty(PKP)in patients with traumatic thoracolumbar fracture.【Methods】A total of 100 patients with traumatic thoracolumbar fracture treated in our hospital from April 2019 to April 2021 were selected and divided into the observation group and the control group according to different surgical methods,with 50 cases in each group.Patients in the observation group received treatment of PKP combined with CPC filler,while patients the control group received PKP combined with polymethyl methacrylate bone cement(PMMA)filler.The biomechanical characteristics of the two groups were compared,and the operative time,intraoperative blood loss,bed-staying length,hospitalization time,postoperative efficacy and complications were compared between the two groups.The vertebral height,visual analogue scale(VAS)score,Cobb Angle,Oswestry Disability Index(ODI)score of the injured vertebra were evaluated before and 6 months after surgery.【Results】The flexural strength,fracture work and elastic modulus of CPC filler were superior to those of PMMA filler(P<0.05).There was no significant difference in total curative effect between the two groups(P>0.05).There was no significant difference in operation time,intraoperative blood loss,bed-staying time and hospitalization between the two groups(P>0.05).There was no significant difference in the height of middle body,front edge and posterior edge between the two groups before and after surgery(P>0.05).The anterior margin height,middle height and posterior margin height of injured vertebrae in both groups were significantly higher than those before surgery(P<0.05).There was no significant difference in VAS score,Cobb Angle and ODI score between the two groups before and after surgery(P>0.05).VAS score,Cobb Angle and ODI score in the two groups after surgery were lower than those before surgery(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).【Conclusion】CPC and PMMA were used in PKP for the treatment of traumatic thoracolumbar fractures.Both methods can improve the treatment efficiency and lumbar function,but CPC has higher and better biomechanical properties and is more in line with the biological requirements of orthopedic fillings.