CAJ | 학술논문

目的：观察自制弹性弧形骨钻在体外骨质疏松椎体成形术中的手术效果，从而探讨其在椎体成形术中的应用价值。方法采用乙二胺四乙酸二钠盐（ EDTA-Na2）浸泡法制备小牛体外骨质疏松椎体，将40个骨质疏松椎体随机分为A、B两组，每组各20个椎体行椎体成形术，A组行常规直钻穿刺，B组采用自制弹性弧形骨钻穿刺，弧形方向朝向穿刺对侧，深度达到椎体中前1/3终止，对两组穿刺骨钻及骨水泥是否达到或越过椎体矢状中线进行统计分析。结果 EDTA-Na2浸泡法脱钙9 d时成功制备出体外骨质疏松椎体，直钻穿刺组钻头达到或越过椎体矢状中线有7个椎体，骨水泥分布达到或越过椎体矢状中线11个；弹性弧形骨钻组穿刺钻头达到或越过椎体矢状中线有18个椎体，骨水泥分布达到或越过椎体矢状中线19个，两组骨钻穿刺效果及骨水泥分布上的差异有统计学意义（ P<0.05）。A组9个椎体发生骨水泥椎管内渗漏，B组4个椎体发生骨水泥椎管内渗漏，两组间在骨水泥渗漏上差异无统计学意义（P>0.05）。结论自制弹性弧形骨钻通过一侧椎弓根穿刺，可以建立一个达到或越过椎体矢状中线的骨性通道，引导骨水泥向穿刺对侧分布，避免了双侧椎弓根穿刺的弊端，其实验效果优于直骨钻。
목적：관찰자제탄성호형골찬재체외골질소송추체성형술중적수술효과，종이탐토기재추체성형술중적응용개치。방법채용을이알사을산이납염（ EDTA-Na2）침포법제비소우체외골질소송추체，장40개골질소송추체수궤분위A、B량조，매조각20개추체행추체성형술，A조행상규직찬천자，B조채용자제탄성호형골찬천자，호형방향조향천자대측，심도체도추체중전1/3종지，대량조천자골찬급골수니시부체도혹월과추체시상중선진행통계분석。결과 EDTA-Na2침포법탈개9 d시성공제비출체외골질소송추체，직찬천자조찬두체도혹월과추체시상중선유7개추체，골수니분포체도혹월과추체시상중선11개；탄성호형골찬조천자찬두체도혹월과추체시상중선유18개추체，골수니분포체도혹월과추체시상중선19개，량조골찬천자효과급골수니분포상적차이유통계학의의（ P<0.05）。A조9개추체발생골수니추관내삼루，B조4개추체발생골수니추관내삼루，량조간재골수니삼루상차이무통계학의의（P>0.05）。결론자제탄성호형골찬통과일측추궁근천자，가이건립일개체도혹월과추체시상중선적골성통도，인도골수니향천자대측분포，피면료쌍측추궁근천자적폐단，기실험효과우우직골찬。
Objective To evaluate the effect of elastic curved bone drill unit upon percutaneous vertebroplasty. Methods Calf osteoporosis vertebral were prepared with EDTA-Na2 immersion in vitro. 40 osteoporotic vertebral bodies were randomly divided into group A and B. Each group had 20 vertebral bodies for vertebroplasty. Group A underwent routine straight bone drill puncture. Group B accepted self-made elastic curved bone drill unit puncture. Puncture were directed toward the other side,depth to the first 1/3 termination of vertebral body,statistical analysis the two groups of puncture bone drill and bone ce-ment which achieved or over the sagittal midline. Results EDTA-Na2 immersion decalcified for 9 days successfully induced vertebral bodies osteoporotic in vitro. 7 vertebral bodies of Group A that drill bit reach or over vertebral sagittal midline,11 ver-tebral bodies showed bone cement distribution beyond the vertebral sagittal midline. 18 vertebral bodies of Group B that drill bit reach or over vertebral sagittal midline,19 vertebral bodies showed bone cement distribution beyond the vertebral sagittal mid-line. The effect of drilling and distribution of bone cement on the two groups had statistical significance(P<0. 05). 9 vertebral bodies of Group A experienced intraspinal bone cement leakage,but 4 happened in group B,the leakage of bone cement showed no significant difference between Group A and B(P> 0. 05). Conclusion The self made elastic curved bone drill unit can build an osseous channel that reach or beyond the vertebral sagittal midline only through one side transpedicular puncture,then guided bone cement distributed to the other lateral of puncture,it will avoid the disadvantages of bilateral pedicle puncture. The result show that the self made elastic curved bone drill unit has adventage in vertebroplasty than that of traditional straight bone drill.