CAJ | 학술논문

目的观察在兔骨质疏松模型中行经皮椎体后凸成形术(PKP)和开放复位内固定手术对邻近腰椎生物力学功能的影响.方法将新西兰大白兔通过切除双侧卵巢建立骨质疏松模型,造模成功42只,分为两组,A组21只,予以行开放复位内固定手术;B组21只,予以PKP手术,观察两组模型术后椎体弯曲和压缩实验最大载荷量的变化,椎体术后平均高度和矢状面Cobb角的改变.结果两组兔模型行PKP和开放复位内固定术术后椎体承载压力能力得到了显著提升,手术前差异有统计学意义(P＜0.01),B组术后椎体承载压力能力提高较A组明显,其差异有统计学意义(P＜0.05).但术后6、12、18个月两组模型承载压力能力逐渐下降.术后观察18个月,A组手术椎体术后平均高度和矢状面Cobb角均无明显变化,B组模型18个月后手术椎体前缘平均高度由术前(38.81±4.12)％恢复至(80.17±8.38)％,矢状面Cobb角由术前(30.13±4.27)°恢复至(8.69±2.41)°.B组椎体术后高度测量值和Cobb角的变化与A组比较,差异有统计学意义(P＜0.05).结论 PKP较开放复位内固定手术可更好地改善邻近椎体后凸角度,更显著地改善椎体承载压力的能力,PKP治疗骨质疏松安全有效.
목적 관찰재토골질소송모형중행경피추체후철성형술(PKP)화개방복위내고정수술대린근요추생물역학공능적영향.방법 장신서란대백토통과절제쌍측란소건립골질소송모형,조모성공42지,분위량조,A조21지,여이행개방복위내고정수술;B조21지,여이PKP수술,관찰량조모형술후추체만곡화압축실험최대재하량적변화,추체술후평균고도화시상면Cobb각적개변.결과 량조토모형행PKP화개방복위내고정술술후추체승재압력능력득도료현저제승,수술전차이유통계학의의(P＜0.01),B조술후추체승재압력능력제고교A조명현,기차이유통계학의의(P＜0.05).단술후6、12、18개월량조모형승재압력능력축점하강.술후관찰18개월,A조수술추체술후평균고도화시상면Cobb각균무명현변화,B조모형18개월후수술추체전연평균고도유술전(38.81±4.12)％회복지(80.17±8.38)％,시상면Cobb각유술전(30.13±4.27)°회복지(8.69±2.41)°.B조추체술후고도측량치화Cobb각적변화여A조비교,차이유통계학의의(P＜0.05).결론 PKP교개방복위내고정수술가경호지개선린근추체후철각도,경현저지개선추체승재압력적능력,PKP치료골질소송안전유효.
Objective To research the changes of lumbar biomechanical function of rabbit model after open reduction and internal fixation and percutaneous kyphoplasty (PKP).Methods New Zealand rabbits were ovariectomized to establish osteoporosis through model,model was successful in 42 cases,divided into two groups,21 rats in group A,be for open reduction and internal fixation operation,21 rats in group B underwent PKP operation,to observe the changes of the two groups,the model of vertebral compression bending and maximum load experiment content,change of bone mineral density (BMD),change of average height and the sagittal Cobb angle of the vertebral body after operation.Results Two groups of rabbit model after PKP (group B) and open reduction and internal fixation operation(group A),the vertebral bearing pressure ability has been significantly improved compared with before operation,the difference was statistically significant (P ＜ 0.01),group B of postoperative vertebral bearing pressure ability improved obviously compared with group A,the difference has statistical significance (P ＜ 0.05).But after 6 months,12 months and 18 months,two groups of model bearing pressure ability declines.Observation of 18 months after operation,operation in group A with vertebral average height and sagittal Cobb angle compared with the preoperative,no significant difference (P ＞ 0.05),18 months after the operation of anterior vertebral height by the average preoperative (38.81 ±4.12)％ and (80.17 ±8.38)％ recovery percent in group B,sagittal Cobb angle by preoperative (30.13 ± 4.27) ° recovered to the (8.69 ± 2.41) °.Group B with BMD,vertebral height and Cobb angle measurement value changes compared with the group A,the difference has statistical difference (P ＜ 0.05).Conclusion Compared with open reduction and internal fixation operation,PKP can better improve vertebral body and adjacent vertebral kyphosis angle,significant bearing pressure,PKP is safe and effective in the treatment of osteoporosis,worthy of promotion.