CAJ | 학술논문

目的：比较通过弧形骨钻与直骨钻注入骨水泥在骨质疏松模型中分布，评价弧形骨钻治疗骨质疏松骨折的应用价值。方法对40个新鲜小牛胸腰椎椎体标本( T10～L5)通过乙二胺四乙酸二钠( EDTA-Na2)脱钙法建立骨质疏松椎体模型。采用随机数字表随机分为两组，每组20例，实验组采用弧形骨钻，对照组采用临床常用直骨钻。在透视下分别进行椎弓根穿刺，分别记录骨钻尖端越过椎体中线的数量及骨钻尖端至椎体中线距离，然后在透视下行经皮椎体成形术( percutaneous vertebroplasty，PVP )，记录骨水泥分布情况及骨水泥渗漏率。结果实验组和对照组骨钻尖端越过椎体中线的椎体数分别是18个和7个；弧形骨钻与直骨钻尖端至椎体中线距离分别为(4.5±0.6) mm 和(1.1±1.5) mm，差异有统计学意义(P＜0.05)；弧形骨钻组与直骨钻组骨水泥注入量分别为(5.5±1.4) ml 和(4.1±1.1) ml，差异有统计学意义(P＜0.05)；弧形骨钻组与直骨钻组骨水泥分布达到或过中线分别是19例与11例，骨水泥渗漏数分别为4例与9例。结论实验证明弹性弧形骨钻可以改变穿刺通道的方向，且能引导骨水泥的分布，实现单侧穿刺骨水泥椎体两侧都能均衡分布的目的。
목적：비교통과호형골찬여직골찬주입골수니재골질소송모형중분포，평개호형골찬치료골질소송골절적응용개치。방법대40개신선소우흉요추추체표본( T10～L5)통과을이알사을산이납( EDTA-Na2)탈개법건립골질소송추체모형。채용수궤수자표수궤분위량조，매조20례，실험조채용호형골찬，대조조채용림상상용직골찬。재투시하분별진행추궁근천자，분별기록골찬첨단월과추체중선적수량급골찬첨단지추체중선거리，연후재투시하행경피추체성형술( percutaneous vertebroplasty，PVP )，기록골수니분포정황급골수니삼루솔。결과실험조화대조조골찬첨단월과추체중선적추체수분별시18개화7개；호형골찬여직골찬첨단지추체중선거리분별위(4.5±0.6) mm 화(1.1±1.5) mm，차이유통계학의의(P＜0.05)；호형골찬조여직골찬조골수니주입량분별위(5.5±1.4) ml 화(4.1±1.1) ml，차이유통계학의의(P＜0.05)；호형골찬조여직골찬조골수니분포체도혹과중선분별시19례여11례，골수니삼루수분별위4례여9례。결론실험증명탄성호형골찬가이개변천자통도적방향，차능인도골수니적분포，실현단측천자골수니추체량측도능균형분포적목적。
Objective To compare the distribution of bone cements injected by curved bone drill or straight bone drill in a vertebralosteoporosis model, and to further assess the application value of curved bone drill in the treatment of osteoporotic fractures.Methods Forty fresh calf thoracolumbar vertebral specimens ( T10-L5 ) that were soaked in ethylene diamine tetraacetic acid ( EDTA )-Na2 were prepared to construct the vertebral osteoporosis model in vitro. The samples were randomly divided into 2 groups,with 20 vertebral specimens in each group. The curved drill was used in the experimental group, and the straight drill was used in the control group. The vertebral pedicle puncture was performedunder the guide of X-ray, and the distances between the top of the drill to the middle-line of the vertebral body and the numbers of the top passed the middle line were measured. Percutaneous vertebroplasty ( PVP ) was also performed under the guide of x-ray, and the distribution and leakage rate of bone cements were recorded.Results The numbers of the top passed the middle line were 18 in the curved drill group and 7 in the straight drill group. The distances between the top of the drill to the middle-line of the vertebral body were ( 4.5±0.6 ) mm in the curved drill group and ( 1.1±1.5 ) mm in the straight drill group. There were statistically signiifcant differences in the number and distance between the 2 groups (P<0.05 ). The volumes of bone cements injected to the vertebra were ( 5.5±1.4 ) ml in the curved drill group and ( 4.1±1.1 ) ml in the straight drill group, and the differences were also statistically signiifcant (P<0.05 ). The numbers that the edge of bone cements reached or passed the middle line were 19 in the curved drill group and 11 in the straight drill group. The numbers ofbone cement leakage were 4 in the curved drill group and 9 in the straight drill group.Conclusions The model experiment shows the direction of puncture can be changed via the curved drill, andthe distribution of bone cementsis guided by the curved drill. The bone cementscan beequally distributed into both sides of the vertebra via unilateral puncture.