| 张贤森,王志坤,谢文伟,等.动物骨质疏松模型椎体成形术中复合应用骨水泥与同种异体骨疗效观察[J].安徽医药,2020,24(10):2024-2028. |
| 动物骨质疏松模型椎体成形术中复合应用骨水泥与同种异体骨疗效观察 |
| Curative effect of vertebroplasty with bone cement combined with allogeneic bone on animal model of osteoporosis |
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| DOI：10.3969/j.issn.1009?6469.2020.10.027 |
| 中文关键词: 骨质疏松性骨折/外科学 骨水泥成形术 骨移植 同种异体骨 牛 |
| 英文关键词: Osteoporotic fractures/ surgery Cementoplasty Bone transplantation Allogeneic bone Cattle |
| 基金项目:东莞市社会科技发展(重点)项目(2018507150241633) |
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| 中文摘要: |
| 目的比较在动物椎体骨质疏松模型椎体成形(PVP)术中使用骨水泥与同种异体骨效果差异。方法 2019年 1—5月从医院动物中心获得 10个生长状况良好小牛，选择位于 T9-L4椎体层面胸腰椎体标本 40个制作成小牛椎体骨质疏松模型，按照随机分组法分为单一骨水泥组、骨水泥 +同种异体骨组，两组均有 20个小牛椎体骨质疏松模型，在 PVP术中单一骨水泥组使用 Mendec骨水泥，骨水泥 +同种异体骨组则使用 Mendec骨水泥与 Bio?gene同种异体骨 1∶1组合物。对两组模型骨水泥填充率，注入前后椎体高度与科伯(cobb)角度以及生物力学变化进行比较。结果两组模型不同层面骨水泥填充率:第 4层面＜第 1层面＜第 3层面＜第 2层面，骨水泥 +同种异体骨组第 4层面与其他三层面比较差异有统计学意义［(36.29±8.34)%、(45.59±13.46)%、(56.32±15.67)%、(52.54±15.81)%；P＜0.05］，单一骨水泥组第 4层面与第 2、3层面比较差异有统计学意义［(31.20±6.34)%、(43.54±10.24)%、(40.22±9.46)%；P＜0.05］，骨水泥 +同种异体骨组不同层面骨水泥填充率显著高于单一骨水泥组；两组模型注入后椎体前缘高度与后缘高度与注入前比较明显增大， Cobb角与注入前比较明显减小［单一骨水泥组:(43.36±3.71)%比(7.45±4.27)%，(32.35±4.33)%比(28.62±2.53)%，(25.36±4.59)°比(30.69±3.51)°；P＜0.05。骨水泥 +同种异体骨组:(50.33±6.14)%比(37.52±4.36)%，(36.34±3.62)%比(28.46±2.35)%，(20.13±4.24)°比(30.34±3.26)°；P＜0.05］，注入后骨水泥 +同种异体骨组椎体前后缘与 Cobb角变化高于单一骨水泥组(P＜0.05)；两组骨水泥注入后刚度、强度显著和骨密度明显上升［单一骨水泥组:(206.33±12.73)比(84.94±11.79)N/mm，(2.93±0.53)比(2.15±0.76)kN，(0.51±0.15)比(0.31±0.19)g/cm2； P＜0.05。骨水泥 +同种异体骨组:(156.22±36.25)比(86.61±12.53)N/mm，(2.59±0.42)比(2.18±0.72)kN，(0.63±0.20)比(0.33± 0.18)g/cm2；P＜0.05］，注入后骨水泥 +同种异体骨组刚度、强度与骨密度变化显著优于单一骨水泥组(P＜0.05)。结论动物椎体骨质疏松模型 PVP术中采用骨水泥+同种异体骨复合组可以明显改善疏松椎体力学性能和后凸角度。 |
| 英文摘要: |
| Objective To compare the effects of bone cement and allogeneic bone applied in percutaneous vertebroplasty(PVP)for animal model of vertebral osteoporosis.Methods Forty thoracolumbar vertebral specimens at T9?L4 vertebra layersfrom 10 calfwith good condition in animal center of the hospital from January to May 2019 were collected to establish calf models of vertebralosteoporosis.They were assigned into bone cement alone group and bone cement with allogeneic bone group by random groupingmethod，with 20 models in each group.During PVP，the bone cement group was treated with Mendec bone cement，while the bone cement with allogeneic bone group was treated with Mendec bone cement combined with Bio?gene allogeneic bone at a ratio of 1:1. The bone cement filling rates，changes in vertebral heights，Cobb angles and biomechanics were compared between the 2 groups.Re? sults The order of bone cement filling rate at different levels from low to high was as follows:the 4thlevel［(36.29±8.34)%］，the 1stlevel［(45.59±13.46)%］，the 3rdlevel［(56.32±15.67)%］and the second level［(52.54±15.81)%］.There were significant differ? ences between the 4thlevel and the other three levels in bone cement with allogeneic bone group(P＜0.05).There were significant differences between the 4thlevel［(31.20±6.34)%］and the 2nd level［(43.54±10.24)%］，3rdlevel［(40.22±9.46)%］in bone cement alone group(P＜0.05).The bone cement filling rates at different layers in bone cement with allogeneic bone group were significant?ly higher than those in bone cement alone group.After injection，the anterior and posterior vertebral heights of the two groups were significantly increased，while Cobb angles were significantly decreased［bone cement alone group:(43.36±3.71)% vs.(7.45±4.27)%，(32.35±4.33)% vs.(28.62±2.53)%，(25.36±4.59)°vs.(30.69±3.51)°；bone cement + allogeneic bone group:(50.33±6.14)% vs.(37.52±4.36)%，(36.34±3.62)% vs.(28.46±2.35)%，(20.13±4.24)°vs.(30.34±3.26)°］(all P＜0.05).After injection， changesof anterior and posterior vertebral heights，and Cobb angle of bone cement with allogeneic bone group were greater than those in bone cement alone group(P＜0.05).The stiffness，strength and bone mineral density of both groups were significantly in? creased［bone cement alone group:(206.33±12.73)vs.(84.94±11.79)N/mm，(2.93±0.53)vs.(2.15±0.76)kN，(0.51±0.15)vs.(0.31±0.19)g/cm2；bone cement + allogeneic bone group:(156.22±36.25)vs.(86.61±12.53)N/mm，(2.59±0.42)vs.(2.18±0.72)kN，(0.63± 0.20)vs.(0.33±0.18)g/cm2］(all P＜0.05).After injection，changes in stiffness，strength and bone density in bone cement with alloge?neic bone group were significantly better than those in bone cement alone group(P＜0.05).Conclusion The application of bonecement and allogeneic bone in PVP for animal model of vertebral osteoporosis can effectively improve biomechanical properties andkyphosis angle of the loose vertebra. |
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