| To study the changes in the strength and stiffness of the vertebral body after kyphoplasty for osteoporotic vertebral compression fractures.Select 6 adult healthy sheep from the same pasture,all 20.4±1.6 months old,weight control at 40.7±2.6Kg,select L1-5 vertebral bodies,total 30 vertebral bodies,and randomly divide them into 3 groups A,B,and C.Each group has 10 vertebrae.Kyphoplasty was performed with low-temperature bone cement infusion in group A,kyphoplasty was performed routinely in group B,and neither balloon dilation nor bone cement was infused in group C.The bone mineral density of the 3 groups of vertebral bodies was measured by the dual-energy X-ray bone mineral density meter.There was no significant difference in bone mineral density between the 3 groups of vertebral body groups(P>0.05).Use the rapid dilute hydrochloric acid method to prepare the osteoporosis model.Use a tap with a diameter of 3mm to drill along the bilateral pedicles of the vertebral body to 1/3 of the anterior wall of the vertebral body,and then soak the vertebral body in 3% dilute hydrochloric acid.Place the infusion catheter into the bilateral pedicle channels and pump dilute hydrochloric acid uniformly at a speed of 60ml/h with the help of a micropump to achieve uniform decalcification inside and outside the vertebral body.After4 hours of decalcification,the vertebral body was taken out of dilute hydrochloric acid,and the surface of the vertebral body and the internal channels of the pedicle were repeatedly washed with 0.9% normal saline to retain dilute hydrochloric acid until the washing solution was detected by the PH test paper and there was no residual hydrochloric acid.Stop washing.The dual-energy X-ray bone densitometer was used to measure the bone mineral density of the vertebral body after decalcification.There was no significant difference in the bone density of the three groups after vertebral body decalcification(P>0.05),and the bone density of the vertebral body after decalcification in the three groups was lower.Significantly decreased before decalcification(P<0.05).After successful decalcification,a vertebral compression fracture model was further prepared on this basis.Before compression,the height of the anterior edge of the three groups of vertebral bodies was measured and recorded with a vernier caliper.There was no statistical difference in the height of the anterior edge of the three groups of vertebral bodies(P>0.05),And then compress the vertebral body with a biomechanical compressor,and the compression amount is 1/4 of the height of the anterior edge of the vertebral body.After compression,record the strength and stiffness of the vertebral body and the height of the anterior edge of the vertebral body after compression.After the compression fracture model is successfully prepared,a 3mm diameter tap is used to puncture the bilateral pedicles to the anterior 1/3 of the vertebral body to prepare a working channel.Place the balloon along the channel in the vertebral body,and under C-arm perspective A After balloon expansion,group B was perfused with low-temperature bone cement infusion technology,group B was perfused with traditional method after balloon expansion,and group C was not perfused with bone cement.Place the vertebral body at room temperature for 24 hours after the bone cement has solidified,and perform CT scan on the vertebral body.Record the bone cement distribution in the vertebral bodies of groups A and B.The strength and stiffness of the vertebral bodies in the three groups after surgery,the height of the anterior edge of the vertebral body,and bone cement penetration Leakage situation.After kyphoplasty,the height of the anterior edge of the vertebral body in the three groups A,B,and C was lower than that before the operation,and the difference was statistically significant(P<0.05).There was no significant difference in the height of the anterior edge of the vertebral body in groups A and B after operation(t=0.472,P>0.05).The height of the anterior edge of the vertebral body after compression in group C was smaller than that in groups A and B(F=45.625,P<0.001).There was no significant difference in the strength and stiffness of the vertebral body before vertebral body fracture in the groups A,B,and C(P>0.05).The strength and stiffness of the vertebral body in groups A and B were higher than those in group C after the operation,and the difference was statistically significant(F=47.179),P<0.05).The strength of the vertebral body in groups A and B was lower than before the fracture after operation,and the difference was statistically significant(P<0.05).The postoperative vertebral body strength in group A was higher than that in group B,and the difference was statistically significant(P<0.05).The stiffness of the vertebrae in each group was compared with that before the fracture.Group A(t=5.699,P<0.001),Group B(t=8.977,P<0.01),Group C(t=6.080,P<0.001),the difference was statistically significant(P<0.05),each group The stiffness of the posterior vertebrae is less than that before the fracture.The stiffness of the vertebral body in groups A and B was higher than that in group C after operation(F=13.995,P<0.001),and the difference was statistically significant.Kyphoplasty can partially restore the vertebral body stiffness,but not completely to the state before the fracture.Comparison of postoperative vertebral stiffness between groups A and B(t=1.707,P=0.105),the difference was not statistically significant(P>0.05).In kyphoplasty,either low-temperature bone cement infusion technology or conventional bone cement infusion technology can improve the strength and rigidity of the fractured vertebral body,but its strength and rigidity cannot be restored to the state before the fracture.However,compared with the conventional bone cement infusion technology,when the same bone cement dosage is infused,the low-temperature bone cement infusion technology improves the strength of the surgical vertebral body more significantly.The use of low-temperature bone cement technology can effectively reduce the complication of bone cement leakage and reduce the risk of surgical leakage.Low-temperature bone cement infusion technology is an effective method during kyphoplasty. |
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