CAJ | 학술논문

目的通过离体实验评价两阶段注射法在椎体成型术中对骨水泥渗漏的预防作用.方法 50个新鲜绵羊腰椎随机分成实验组及对照组.分别采用两阶段注射法及常规椎体成型方法,在X线透视引导下向椎体内注射总量为3 mL的PMMA,模拟临床椎体成型术.实验组首先向椎体后部注射0.5 mL的PMMA,待其固化后,再次向椎体内注射2.5 mL的PMMA.对照组以常规方法向椎体内注射3 mL的PMMA.通过X线及肉眼直视,统计两组骨水泥渗漏的发生率.结果对照组有8例出现骨水泥向椎管内渗漏,而实验组中仅2例,显著低于对照组(P=0.032).尽管实验组骨水泥总体渗漏发生率56%高于对照组44%,但无统计学差别.结论两阶段注射法可显著降低骨水泥向椎管内方向渗漏的发生率.
목적 통과리체실험평개량계단주사법재추체성형술중대골수니삼루적예방작용.방법 50개신선면양요추수궤분성실험조급대조조.분별채용량계단주사법급상규추체성형방법,재X선투시인도하향추체내주사총량위3 mL적PMMA,모의림상추체성형술.실험조수선향추체후부주사0.5 mL적PMMA,대기고화후,재차향추체내주사2.5 mL적PMMA.대조조이상규방법향추체내주사3 mL적PMMA.통과X선급육안직시,통계량조골수니삼루적발생솔.결과 대조조유8례출현골수니향추관내삼루,이실험조중부2례,현저저우대조조(P=0.032).진관실험조골수니총체삼루발생솔56%고우대조조44%,단무통계학차별.결론 량계단주사법가현저강저골수니향추관내방향삼루적발생솔.
Objective To determine the preventable effect of a staged-injection procedure in cement leakage during vertebroplasty.Methods 50 vertebral bodies (L1-L5) were harvested from each of 10 osteoporotic sheep (3±1 years),screened for bone density and disarticulated.PMMA was injected into vertebral bodies by the two-stage injection procedure (group A) and the conventional injection procedure (group B).In group A,0.5 mL cement was injected at first stage.15 minutes later,after the cement solidified,another 2.5 mL cement was injected into the center part of the vertebral bodies through transpedicular approach.In group B,vertehroplasty was performed through the transpedicular approach as usual.When the tip of the needle reached aim area of vertebral bodies,3.0 mL cement was injected one time.Cement leakage rates were recorded.Results The two-stage injection procedure resulted in a significant decrease in the epidural or canal leakage rate.Additionally,the paravertehral leakage rate was higher in two-stage injection procedure (56%) than in conventional injection procedure (44%).However,no significant difference was found for the total cement leakage rate in two groups.Conclusion Compared with conventional procedure,the twostage injection procedure in vertebroplasty decreased incidence of epidural and canal leaks.The first-stage injecting PMMA can be a barrier to the epidural extravasation of cement during vertebroplasty.