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1、·1616·中国矫形外科杂志 2003年12月第11卷第23期 OrthopJChin,Vol.11,No.23December2003·实验研究·磷酸钙骨水泥强化椎弓根螺钉对骨质疏松性椎体骨折的临床意义杨述华 傅德皓 刘昌胜 李 进 刘国辉 许伟华 杨 操 李 鲲 汪 岚摘 要 目的:评价磷酸钙骨水泥(calciumphosphatecement,CPC)强化和修复椎弓根螺钉的生物力学效果。方法:6具新鲜老人骨质疏松的脊柱标本,从T11～L4共36个椎体,随机选取其中32个,分为4组,每组8个。A组:随机选择一侧椎弓根放置直径为6.5m
2、m的椎弓根螺钉,另一侧以直径为3.5mm的钻头导孔。向两侧椎弓根孔道注入配制好的磷酸钙骨水泥(CPC)3～5ml,体温下(37℃)放置24h后,再行前述拔出实验。B组:应用PMMA进行修复和强化,作为对照,操作方法同A组。C组:植入椎弓根螺钉,添加或不添加CPC,进行周期抗屈实验。D组:相同方法,应用PMMA作为对照。结果:CPC骨水泥强化组和修复组拔出力明显高于对照组,差异有显著性意义(P<0.05)。结论:在植入椎弓根螺钉时添加具有生物活性的磷酸钙(CPC)骨水泥可显著提高其初始稳定性。关键词 椎弓根螺钉; 生物力学; 骨质疏松; 磷
3、酸钙骨水泥中图分类号 R683.2文献标识码 A文章编号 1005-8478(2003)23-1616-03AugmentationandRestorationofPedicleScrewFixationwithCalciumPhosphateCementforOsteoporoticSpineFrac2ture:AninvitroBiomechanicalStudy∥YANGShu2hua,FUDe2hao,LIUChang2sheng,etal.DepartmentofOrthopaedics,UnionHospitalofTongj
4、iMedicalCollegeofHuazhongScienceandTechnologyUniversity,Wuhan430022AbstractObjective:Toevaluatepediclescrewfixationstrengthfollowingaugmentationandrestorationwithcalciumphos2phatecement(CPC).Methods:Atotalofthirty2twofreshthoracolumbarvertebraeofsixadultcadaverswereemploy
5、edinthisexperiment.Thespecimenswererandomlydividedintofourgroups,eachgroupincludedeightvertebrae(T11～L4).GroupA:self2designedscrewsof6.5mmdiameterwereimplantedintothepedicleunilaterally.Andapilotholewascreatedusing3.5mmdrillcontralaterallyoneightfreshhumanthoracolumbarver
6、tebrae.Neitherthescrewsnorthedrillingspenetratedthean2teriorcortexofthevertebralbodies.TheCPCwasappliedtotheholesandallowedtohardenfor24hours,thenthepullouttestwasemployedagain.GroupB:thesametestasgroupAwasemployed,butpediclescrewswereaugmentedandrestoredwithPMMA.GroupC:p
7、ediclescrewswereimplantedwithorwithoutCPCaugmentationbilaterally,thencyclibendingre2sistancetestwasemployed.GroupD:thesametestasgroupCwasemployed,butpediclescrewswereaugmentedwithPM2MA.Results:ThepulloutstrengthfollowingCPCrestorationandaugmentaitonwassignificantlygreater
8、thanthatofcontrolgroup(P<0.05.Conclusion:ThistestdemonstratesthatrestorationandaugmentationwithC
