摘要
目的:评价纳米羟基磷灰石骨水泥(Nano-HAC)在骨质疏松椎体中强化和翻修椎弓根螺钉的作用。方法:采用4具女性尸体椎骨,CT扫描测量胸腰椎骨密度(BMD)。其中两套胸腰椎的BMD属Ⅱ级骨质疏松,为1组;其余两套胸腰椎属Ⅲ级骨质疏,为2组。用丝锥在两侧椎弓根攻出导孔,随机选择一侧置入AF螺钉为对照侧,另一侧注入Nano-HAC3ml,然后拧入AF螺钉作为强化侧。在室温下保存24h后测量两侧椎弓根螺钉的最大轴向拨出力(F-max)。用Nano-HAC翻修对照侧钉道,植入同样大小的AF螺钉为翻修侧,室温下保存24h后测量翻修侧椎弓根螺钉的F-max。结果:在1组中强化侧和翻修侧椎弓根螺钉的F-max分别为:(841.00±27.35)、(830.00±19.54)N,与对照侧(494.00±11.66)N比较分别提高了70.2%和68.01%,差别有显著性意义(P<0.01);2组对照侧、强化侧、翻修侧F-max分别为(419.00±13.33)、(778.00±27.90)、(771.00±26.44)N,强化侧较对照侧增加了86%,翻修侧较对照侧增加了84%,差异有显著性(P<0.05)。结论:Nano-HAC在Ⅱ、Ⅲ级骨质疏松椎体中有良好的强化和翻修椎弓根螺钉作用,F-max可达到或接近正常稳定性水平。
Objective： To evaluate the effects of Nano-hydroxyapatite on strengthening and revising of pedicle screws in osteoporotic spine. Methods： 4 female cadaveric spines from T8-L5 were harvested. BMD of specimen were measured using CT technique. According to the diagnostic criteria of osteoporosis, 2 specimens were typed as Ⅱ degree of osteoporosis and another two as Ⅲ degree. For each vertebral body, an AF pedicle screw was inserted into either the right or left pedicle as control side, and 3.0ml Nano-hydroxyapatite cement was injected into prepared pedicle hole before implanting as strengthen side. Axial pullout tests were then performed using MTS testing machine after 24 hours. 3.0ml cement was injected into the failed screw hole, and the same screw reinserted was taken as a revision case. After 24 hours, screws were pulled and measured F-max. Results： Among group 1, F-max of strengthening and revising sides were（841.00±27.35）N, and （830.00±19.54） N respectively, increased about 70.2% and 68.01% comparing with that of control side （494.00± 11.66）N （P〈0.01 ）. For group 2, F-max of two sides were （778.00±27.90） N and （771.00±26.44） N, increased about 86% and 84% respectively. Conclusions： Nano-HAC can be used to enhance the effect of screw fixation in osteoporotic vertebrae .The F-max of the pedicle screw in Ⅱ and Ⅲ degree osteoporosis achieved the normal force level after using Nano-HAP cement.
出处
《中国临床解剖学杂志》
CSCD
北大核心
2007年第5期587-589,共3页
Chinese Journal of Clinical Anatomy
关键词
椎弓根螺钉
翻修
强化
骨质疏松
生物力学
pedicle screw
revision
strengthening
osteoporosis
biomechanics
