吉林医学
吉林醫學
길림의학
JILIN MEDICAL JOURANL
2014年
32期
7107-7109
,共3页
张军%王新虎%杜伟%左春光
張軍%王新虎%杜偉%左春光
장군%왕신호%두위%좌춘광
椎体成形术%骨质疏松%压缩骨折%骨钻
椎體成形術%骨質疏鬆%壓縮骨摺%骨鑽
추체성형술%골질소송%압축골절%골찬
Percutaneous kyphoplasty%Osteoporosis%Compression fracture%Bone drill unit
目的：观察自制定向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组、B组，每组20个椎体行椎体成形术，A组行常规直钻穿刺，B组采用自制定向弧形骨钻穿刺，弧形方向朝向穿刺对侧，深度达到椎体中前三分之一终止，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：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；定向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：自制定向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。
目的：觀察自製定嚮弧形骨鑽在體外骨質疏鬆椎體成形術中的手術效果，從而探討其在椎體成形術中的應用價值。方法：採用乙二胺四乙痠二鈉鹽（EDTA-Na2）浸泡法製備小牛體外骨質疏鬆椎體，將40箇骨質疏鬆椎體隨機分為A組、B組，每組20箇椎體行椎體成形術，A組行常規直鑽穿刺，B組採用自製定嚮弧形骨鑽穿刺，弧形方嚮朝嚮穿刺對側，深度達到椎體中前三分之一終止，對兩組穿刺骨鑽及骨水泥是否達到或越過椎體矢狀中線進行統計分析。結果：直鑽穿刺組鑽頭達到或越過椎體矢狀中線有7箇椎體，骨水泥分佈達到或越過椎體矢狀中線11箇；定嚮弧形骨鑽組穿刺鑽頭達到或越過椎體矢狀中線有18箇椎體，骨水泥分佈達到或越過椎體矢狀中線19箇，兩組骨鑽穿刺效果及骨水泥分佈上差異有統計學意義（P＜0.05）。A組9箇椎體髮生骨水泥椎管內滲漏，B組4箇椎體髮生骨水泥椎管內滲漏，兩組間在骨水泥滲漏上差異無統計學意義（P＞0.05）。結論：自製定嚮弧形骨鑽通過一側椎弓根穿刺，可以建立一箇達到或越過椎體矢狀中線的骨性通道，引導骨水泥嚮穿刺對側分佈，避免瞭雙側椎弓根穿刺的弊耑，其實驗效果優于直骨鑽。
목적：관찰자제정향호형골찬재체외골질소송추체성형술중적수술효과，종이탐토기재추체성형술중적응용개치。방법：채용을이알사을산이납염（EDTA-Na2）침포법제비소우체외골질소송추체，장40개골질소송추체수궤분위A조、B조，매조20개추체행추체성형술，A조행상규직찬천자，B조채용자제정향호형골찬천자，호형방향조향천자대측，심도체도추체중전삼분지일종지，대량조천자골찬급골수니시부체도혹월과추체시상중선진행통계분석。결과：직찬천자조찬두체도혹월과추체시상중선유7개추체，골수니분포체도혹월과추체시상중선11개；정향호형골찬조천자찬두체도혹월과추체시상중선유18개추체，골수니분포체도혹월과추체시상중선19개，량조골찬천자효과급골수니분포상차이유통계학의의（P＜0.05）。A조9개추체발생골수니추관내삼루，B조4개추체발생골수니추관내삼루，량조간재골수니삼루상차이무통계학의의（P＞0.05）。결론：자제정향호형골찬통과일측추궁근천자，가이건립일개체도혹월과추체시상중선적골성통도，인도골수니향천자대측분포，피면료쌍측추궁근천자적폐단，기실험효과우우직골찬。
Objective To evaluate the effect of elastic curved bone drill unit upon percutaneous vertebroplasty,in order to explore the application value of intraoperative in vertebroplasty.Methods EDTA-Na2 immersion prepared calf osteoporosis vertebral in vitro,40 osteoporotic vertebral bodies were randomly divided into A and B two groups,each group had 20 vertebral bodies for vertebroplasty.Group A underwent routine straight bone drill puncture,Group B using self made elastic curved bone drill unit puncture,puncture arc direction toward the other side,depth to thefirst 1/3 termination of vertebral body,statistical analysis the two groups of puncture bone drill and bone cement which achieved or over the sagittal midline.Results 7 vertebral bodies of Group A that drill bit reach or over vertebral sagittal midline,11 vertebral 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 midline.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 happened 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,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.
