In Vitro Study Of Fibrin Sealant Applying In The Percutaneous Kyphoplasty

The cement leakage and the range depends on the injection stress ,the subsequent flow and the vascular egress in the vertebral body. So through diminishing the stress, increasing the resistant force, stopping the subsequent and sealing the vascular egress could decrease the cement extravasation. But up to now, except inflatable bone tamps could decrease the cement extravasation from 65% to 8.6%. No other approach which could reduce the leakage exists.Fibrin sealant can form film, seal wound surface and lesson hemorrhage. In this experiment, we injected the sealant into the cavity before the cement injection. And the purpose of this experiment was to observe and study whether the sealant could form a layer of film in the cavity and whether it could reduce the cement leakage in the percutaneous kyphoplasty and find another possible method for the vertebral compression fractures.Material and Method:Vertebral body from L1 to L4 from 6 cadavers were chosen in this experiment. L1 and L2 or L3 and L4 from the same cadaver were put into one group and at last total 9 groups were available. One vertebral body from each group was put into the experimental group and the other into the control group.The cavity was created in the vertebral body by the means of percutaneous kyphoplasty. In the experimental group, the sealant was injected into the cavity before the cement. But the cement was injected into the cavity directly in the control group.After that, we analyzed the cement distribution in the vertebral bodies with the help of X-ray. And then, the vertebral bodies were dissected to observe the cement, sealant and bone directly. At last, the marginal cement which is far from the central part more than 5mm in the experimental group was sliced and checked under the microscope. Result:The leakage rate in the CP is 3/9 and that in the EP is 0/9. The P value is 0.027 and it is less than 0.05. So the leakage rate between CP and EP has significant difference statistically. About the cement distribution in the vertebral bodies in the X-ray film, it also has significant difference statistically between CP and EP. The cement outflow in the CP happens in six vertebral bodies and at nine places in all. But it only happens in two vertebral bodies and at two places. The P value is 0.01 and it is also less than 0.05. Anatomically, a layer of film could be seen between the cement and bone in the cavity. Pathologically, a layer of film also could be seen around the cement.Conclusion:Fibrin sealant could form a layer of film in the cavity. It could increase the force of resistance and decrease the range of subsequent of cement. These advantages above imply that the sealant could make up the insufficiency of inflatable bone tamps and reduce the cement extravasation and the hazard resulting from the extravasation.