[1]张欲燃,汤逊,熊成东,等.可吸收椎体内支撑器的研制及植入途径研究[J].中医正骨,2011,23(07):20-24.
　ZHANG Yu-ran*,TANG Xun,XIONG Cheng-dong,et al.Development of centrum-vertebra-fracture-repairing absorbable supporting plugger and the study of its implantation pathway[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2011,23(07):20-24.
点击复制

可吸收椎体内支撑器的研制及植入途径研究()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第23卷
期数:
2011年07期
页码:
20-24
栏目:
基础研究
出版日期:
2011-07-30

文章信息/Info

Title:
Development of centrum-vertebra-fracture-repairing absorbable supporting plugger and the study of its implantation pathway
作者:
张欲燃1; 汤逊2; 熊成东3; 张茂枢2; 徐永清2; 周田华 2; 刘力2
1.河南省濮阳市中医院,河南 濮阳 457000;
2.中国人民解放军成都军区昆明总医院, 云南 昆明 650032;
3.中国科学院成都有机化学研究所,四川 成都 610041
Author(s):
ZHANG Yu-ran*; TANG Xun; XIONG Cheng-dong; et al.*
Hospital of Chinese medicine of Puyang city,Puyang 457000,Henan,China
关键词:
脊柱骨折 椎体成形术 可吸收椎体内支撑器
Keywords:
Spinal fractures;  Vertebroplasty;  centrum-vertebra-fracture-repairing absorbable supporting plugger
摘要:
目的:研制用于胸腰椎骨折椎体重建的可吸收椎体内支撑器,并探讨经椎弓根植入的可行性。方法:选择100例健康成年志 愿者,CT扫描其T11～L4椎骨,模拟重建T11～L4椎骨的二维、三维图像,测量椎 体矢状径、横径和椎弓根内径高度、宽度。据此确定可植入支撑器的规格,并以聚-DL-乳酸(分子量40～80万)、磷酸三钙或羟基 磷灰石为原料制成成品试件。将成品试件经椎弓根植入3具成人尸体标本的L1、L2椎体中,完成后摄腰 椎标本正侧位X线片,并行L1、L2椎骨CT扫描、矢状面二维重建。结果:T11～ L4椎体横径(32.44±2.82)～(42.13±4.10)mm,椎体矢状径(25.55±2.54)～(28.97±2.24)mm; T11～L4椎弓根内径高度(9.16±1.40)～(12.46±1.67)mm,椎弓根内径宽度(5.78±0.89) ～(8.88±1.51)mm,椎弓根内径高度及宽度两侧相比,差异无统计学意义(T11～L4椎弓根内径高 度:t=1.857,P=0.334; t=1.673,P=0.707; t=2.355,P=0.685; t=1.983,P=0.126; t=2.435,P=0.148; t=2.871,P=0.774。 T11～L4椎弓根内径宽度:t=0.134,P=0937; t=1.962,P=0.125; t=0.453,P=0.634; t=1.983,P=0.509; t=1.643,P=0.086; t=0.851,P=0.150)。②设计的系列可吸收椎体内支撑器规格为:长20.0～27.0 mm,宽7.0～10.0 mm,高9.0～ 12.0 mm。③经X线及CT检查,经椎弓根植入3具成人尸体标本L1、L2椎体中的可吸收椎体内支撑器位置 良好。结论:可吸收椎体内支撑器经椎弓根或经椎弓根及其外侧壁植入重建胸腰椎前中柱是可行的。
Abstract:
Objective:To develop the centrum-vertebra-fracture-repairing absorbable supporting plugger(CASP)used for the vertebral reconstruction after the thoracolumbar fractures,and to explore the feasibility of CASP's implantation via the pedicle of vertebral arch.Methods:One hundred healthy adult volunteers were chosen to reconstruct the 2D and 3D images of T11-L4 vertebras through CT scanning their T11-L4 vertebras,then the vertebral sagittal diameters,the vertebral transverse diameters, heights and widths of pedicle of vertebral arch were measured from above images.After that,the specifications of the implantable supporting pluggers were determined according to above measurements,and the finished product were manufactured from the following 3 materials as poly-DL-lacti acid(molecular weights ranged from 400,000 to 800,000),tricalcium phosphate and hydroxyapatite.The finished product were implanted into L1 vertebra and L2 vertebra of 3 adult cadavers via their pedicles of vertebral arch respectively.Next,PA&LAT X-ray films of the lumbar of cadavers were taken and conserved,L1 vertebra and L2 vertebra were scanned by CT and the image of their sagittal planes were processed with two-dimensional reconstruction.Results:①The transverse diameters of T11-L4 vertebras ranged from(32.44±2.82)mm to(42.13±4.10)mm,and their sagittal diameters ranged from (25.55±2.54)mm to(28.97±2.24)mm; the inner heights of pedicle of vertebral arch ranged from (9.16±1.40)mm to(12.46±1.67)mm,and their inner widths ranged from(5.78±0.89)mm to (8.88±1.51)mm,and there was no statistical difference in the inner heights and inner widths between the both sides of the pedicles of vertebral arch(Inner heights:t=1.857,P=0.334; t=1.673,P=0.707; t=2.355,P=0.685; t=1.983,P=0.126; t=2.435,P=0.148; t=2.871,P=0.774.Inner widths:t=0.134,P=0937; t=1.962,P=0.125; t=0.453,P=0.634; t=1.983,P=0.509; t=1.643,P=0.086; t=0.851,P=0.150).②The specifications of the designed CASP series were as follows:the lengths ranged from 20.0mm to 27.0mm,the widths ranged from 7.0mm to 10.0mm and the heights ranged from 9.0mm to 12.0mm.③The positions of CASP implanted into the L1 vertebra and L2 vertebra of the 3 adult cadavers from their pedicles of vertebral arch were turned out to be well after experiencing the inspection through X-ray and CT scanning.Conclusion:It is feasible to reconstruct the anterior columns and axial columns of thoracolumbar vertebrae through implanting CASP via pedicle or via the pedicle and its lateral wall.

参考文献/References:

[1] 从庆武,徐文联,祝宗华,等.经椎弓根椎体内植骨在胸腰椎骨折术中的应用[J].中医正骨,2010,22(10):67-68,70.
[2] Cho DY,Lee WY,Sheu PC.Treatment of thoracolumbar burst fractures with polymethyl methacrylate vertebroplasty and short-segment pedicle screw fixation[J].Neurosurgery,2003,53(6):1354-1361.
[3] Leferink VJ,Keizer HJ,Oosterhuis JK,et al.Functional outcome in patients with thoracolumbar burst fractures treated with dorsal instrumentation and transpedicular cancellous bone grafting[J].Eur Spine J,2003,12(3):261- 267.
[4] Knop C,Fabian HF,Bastian L,et al.Late results of thoracolumbar fractures after posterior instrumentation and transpedicular bone grafting[J].Spine,2001,26(1):88-99.
[5] Verlaan JJ,Dhert WJ,Verbout AJ,et al.Balloon vertebroplasty in combination with pedicle screw instrumentation:a novel technique to treat thoracic and lumbar burst fractures[J].Spine,2005,30(3):73-79.
[6] Cho DY,Lee WY,Sheu PC,et al.Treatment of thoracolumbar burst fractures with polymethyl methacrylate vertebroplasty and short-segment pedicle screw fixation[J].Neurosurgery,2003,53(6):1354-1361.
[7] Yeom JS,Kim WJ,Choy WS,et al.Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures[J].J Bone Joint Surg Br,2003,85(1):83-89.
[8] Monticelli F,Meyer HJ,Tutsch-Bauer E.Fatal pulmonary cement embolism following percutaneous vertebroplasty (PVP)[J].Forensic Sci Int,2005,149(1):35-38.
[9] Grados F,Depriester C,Cayrolle G,et al.Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty[J].Rheumatology,2000,39(12):1410-1414.
[10] Ignjatovic' N,Tomic' S,Dakic' M,et al.Synthesis and properties of hydroxyapatite/poly-L-lactide composite biomaterials[J].Biomaterials,1999,20(9):809-816.
[11] Li KC,Chen HH,Li A,et al.Safe zone for application of transpedicle body augmenter[J].J Orthop Surg Taiwan,2004,21(3):125-133.
[12] Li KC,Li AF,Hsieh CH,et al.Transpedicle body augmenter in painful osteoporotic compression fractures [J].Eur Spine J,2007,16(5):589-598.

更新日期/Last Update: 2011-07-30