CAJ | 학술논문

背景：由于骨质原因及结构特点导致椎弓根螺钉经常出现把持力下降，从而发生松动、拔出，导致内固定失败，因此提高椎弓根螺钉的稳定性显得尤为重要。 　　目的：检测可注射骨水泥空心椎弓根螺钉椎弓根螺钉生物力学稳定性，为优化骨水泥使用量提供参考。 　　方法：选取7具新鲜成人尸体T11-L4椎体标本共40个椎体，随机分为可注射骨水泥空心椎弓根螺钉及DTPSTM椎弓根螺钉组，各20个，置钉后分别注入1，2，3，5 mL骨水泥，通过影像学观察骨水泥弥散分布情况，并测得最大轴向拔出力进行比较。 　　结果与结论：骨水泥用量为1-3 mL时，可注射骨水泥空心椎弓根螺钉组螺钉平均最大轴向拔出力显著高于DTPSTM组(P <0.05)。骨水泥用量为5 mL时，2组平均最大轴向拔出力差异无显著性意义(P >0.05)。可注射骨水泥空心椎弓根螺钉组的直线回归方程为 Y=25.269X+133.681(R2=0.837)，DTPSTM椎弓根螺钉组的直线回归方程为Y=32.039X+99.251(R2=0.936)。骨水泥用量在1-5 mL时，2组螺钉最大轴向拔出力与骨水泥量高度正相关(|R|>0.8)。说明骨水泥强化椎弓根螺钉可显著提高螺钉稳定性，椎弓根螺钉最大轴向拔出力与骨水泥使用量呈高度正相关，可注射骨水泥空心椎弓根螺钉在达到满意的内固定强化效果同时，减少骨水泥使用量，降低了骨水泥泄漏风险，相比DTPSTM椎弓根螺钉更具有优势。
배경：유우골질원인급결구특점도치추궁근라정경상출현파지력하강，종이발생송동、발출，도치내고정실패，인차제고추궁근라정적은정성현득우위중요。 　　목적：검측가주사골수니공심추궁근라정추궁근라정생물역학은정성，위우화골수니사용량제공삼고。 　　방법：선취7구신선성인시체T11-L4추체표본공40개추체，수궤분위가주사골수니공심추궁근라정급DTPSTM추궁근라정조，각20개，치정후분별주입1，2，3，5 mL골수니，통과영상학관찰골수니미산분포정황，병측득최대축향발출력진행비교。 　　결과여결론：골수니용량위1-3 mL시，가주사골수니공심추궁근라정조라정평균최대축향발출력현저고우DTPSTM조(P <0.05)。골수니용량위5 mL시，2조평균최대축향발출력차이무현저성의의(P >0.05)。가주사골수니공심추궁근라정조적직선회귀방정위 Y=25.269X+133.681(R2=0.837)，DTPSTM추궁근라정조적직선회귀방정위Y=32.039X+99.251(R2=0.936)。골수니용량재1-5 mL시，2조라정최대축향발출력여골수니량고도정상관(|R|>0.8)。설명골수니강화추궁근라정가현저제고라정은정성，추궁근라정최대축향발출력여골수니사용량정고도정상관，가주사골수니공심추궁근라정재체도만의적내고정강화효과동시，감소골수니사용량，강저료골수니설루풍험，상비DTPSTM추궁근라정경구유우세。
BACKGROUND:Bony and structural feature often cause pulout strength decrease of pedicle screw, which induces loosening and pulout, and finaly results in fixation failure. Thus, it is very important to elevate the stability of pedicle screw. OBJECTIVE:To detect the biomechanical stability of bone cement injectable canulated pedicle screw, and to provide reference for bone cement dosage. METHODS: We selected T11-L4 samples of seven fresh adult corpses, containing 40 vertebral bodies. They were randomly divided into bone cement injectable canulated pedicle screw group and DTPSTM pedicle screw group (n=20). After screw implantation, 1, 2, 3 and 5 mL bone cement was injected. The diffuse distribution of bone cement was observed by imaging. The maximum axial pulout strength was measured. RESULTS AND CONCLUSION:When the dose of bone cement was 1-3 mL, the average maximum axial pulout strength was significantly greater in the bone cement injectable canulated pedicle screw group than in the DTPSTM pedicle screw group (P < 0.05). When the bone cement dosage was 5 mL, no significant difference in the maximum axial pulout strength was detected between the two groups (P > 0.05). The regression equation was Y=25.269X+133.681 (R2=0.837) in the bone cement injectable canulated pedicle screw, and Y=32.039X+99.251 (R2=0.936) in the DTPSTM pedicle screw group. When the dosage of bone cement was 1-5 mL, the maximum axial pulout strength was highly positively correlated with bone cement dosage (|R| > 0.8). These results suggested that bone cement augmentation pedicle screw could apparently elevate the stability of the screw. The maximum axial pulout strength of the pedicle screw was positively correlated with bone cement dosage. After reaching the satisfactory fixation effects, the bone cement injectable canulated pedicle screw can reduce bone cement dosage, diminish the risk of bone cement leakage, and have more advantages than DTPSTM pedicle screw.