Cement leakage causes potential thermal injury in vertebroplasty.
Cement leakage causes potential thermal injury in vertebroplasty.
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DOI：
10.1186/1471-2474-12-116
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发表时间：
2011-05-26
影响因子：
2.3
通讯作者：
Nien NY
中科院分区：
文献类型：
--
作者：
Lai PL;Tai CL;Chen LH;Nien NY
经皮椎体成形术采用PMMA骨水泥注入骨折椎体已被广泛接受治疗脊柱压缩性骨折。然而，骨水泥的放热聚合可能引起骨或神经组织损伤。因此，本研究旨在评估经皮椎体成形术中热损伤的潜在风险。将12块猪椎骨浸泡在37°C的生理盐水中进行实验。在研究的第一阶段，模拟无骨水泥渗漏的椎体成形术（对照组，n = 6）。选取椎体前皮质、椎间孔、后皮质和椎体中央进行温度测量。记录峰值温度和45°C以上持续时间等参数。第二阶段，设计模拟骨水泥渗入椎管的模型（n = 6）。温度测量方法与第一阶段相同。在研究的第一阶段（在没有水泥渗漏的情况下对猪椎体进行椎体成形术），前皮质的平均最高温度为42.4±2.2℃；神经孔处39.5±2.1℃；后皮质40.0±2.5°C，椎中心68.1±3.4°C。45°C以上的平均间隔时间在前皮层为0秒；在神经孔处，0秒；后皮层，0秒脊椎中心，223秒。因此，除了骨水泥的核心，椎体周围的温度不超过45°C。在研究的第二阶段（水泥渗漏模型），前皮质的平均最高温度为42.7±2.4℃；神经孔，41.1±0.4°C；后皮质59.1±7.6°C，椎中心77.3±5.7°C。前皮层温度高于45℃的平均时间间隔为0秒；在神经孔处，0秒；在后皮层，329.3秒在椎体中心，393.2秒。根据这些结果，后皮质和椎体中心的温度超过45°C。结果表明，对于局限于椎体内的骨水泥，固化温度不会直接引起附近软组织的热损伤。如果骨水泥渗漏到椎管中，后皮质的放热反应可能导致神经组织的热损伤。
Percutaneous vertebroplasty by injecting PMMA bone cement into the fractured vertebrae has been widely accepted in treatment of spinal compression fracture. However, the exothermic polymerization of bone cement may cause osseous or neural tissue injury. This study is thus designed to evaluate the potential risk of thermal damage in percutaneous vertebroplasty. Twelve porcine vertebrae were immersed in 37°C saline for the experiment. In the first stage of the study, vertebroplasty without cement leakage (control group, n = 6) was simulated. The anterior cortex, foramen, posterior cortex and the center of the vertebral body were selected for temperature measurement. Parameters including peak temperature and duration above 45°C were recorded. In the second stage, a model (n = 6) simulating bone cement leaking into the spinal canal was designed. The methods for temperature measurement were identical to those used in the first stage. In Stage 1 of the study (vertebroplasty of the porcine vertebral body in the absence of cement leakage), the average maximal temperature at the anterior cortex was 42.4 ± 2.2°C; at the neural foramen 39.5 ± 2.1°C; at the posterior cortex 40.0 ± 2.5°C and at the vertebral center, 68.1 ± 3.4°C. The average time interval above 45°C was 0 seconds at the anterior cortex; at the neural foramen, 0 seconds; at the posterior cortex, 0 seconds and at the vertebral center, 223 seconds. Thus, except at the core of the bone cement, temperatures around the vertebral body did not exceed 45°C. In Stage 2 of the study (cement leakage model), the average maximal temperature at the anterior cortex was 42.7 ± 2.4°C; at the neural foramen, 41.1 ± 0.4°C; at the posterior cortex, 59.1 ± 7.6°C and at the vertebral center, 77.3 ± 5.7°C. The average time interval above 45°C at the anterior cortex was 0 seconds; at the neural foramen, 0 seconds; at the posterior cortex, 329.3 seconds and at the vertebral center, 393.2 seconds. Based on these results, temperatures exceeded 45°C at the posterior cortex and at the vertebral center. The results indicated that, for bone cement confined within the vertebra, curing temperatures do not directly cause thermal injury to the nearby soft tissue. If bone cement leaks into the spinal canal, the exothermic reaction at the posterior cortex might result in thermal injury to the neural tissue.
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DOI：
10.1002/jbm.b.20041
发表时间：
2004-04-15
影响因子：
3.4
作者：
Zhao, F;Lu, WW;Yao, KD
通讯作者：
Yao, KD
影响因子：
3
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5.8
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3
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HOMMA, T
影响因子：
2.8
作者：
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通讯作者：
Chung, Kao-Chi