Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model.
Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model.
复制标题
腰椎骨质疏松性爆发裂缝的水泥无钛网固定导致骨愈合：实验绵羊模型的结果。
DOI：
10.1155/2016/4094161
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发表时间：
2016
影响因子：
--
通讯作者：
Gradl G
中科院分区：
文献类型：
--
作者：
Eschler A;Roepenack P;Roesner J;Herlyn PK;Martin H;Reichel M;Rotter R;Vollmar B;Mittlmeier T;Gradl G
导言。目前骨质疏松性椎体压缩骨折(VCFs)的治疗策略主要集中在水泥相关的解决方案上。与骨水泥应用相关的并发症包括渗漏、血栓、邻近骨折和骨质愈合中的损害。本研究建立了绵羊骨质疏松VCF模型，以(1)评价一种新型钛网骨折内固定技术(TMI)，以及(2)验证VCFs在骨质疏松绵羊中的愈合能力。方法：研究方法。12只5岁的美利奴绵羊接受了卵巢切除、皮质类固醇注射和钙/磷/维生素D缺乏的饮食以诱导骨质疏松。标准VCFs(AOA3.1型)用椎体内TMI建立、复位和固定。随机附加自体海绵移植(G1)或不作任何增强(G2，n=6)。术后2个月，进行宏观、微观CT和生物力学评价。结果。所有病例骨折复位均成功，无术中并发症。所有病例都证实了骨质巩固，G2组骨痂发育增加(58.3%)。Micro-CT显示椎间融合。两组在生物力学测试中都没有显示出改善的结果。结论。骨质疏松症绵羊腰椎VCF采用非骨水泥TMI进行骨折复位固定，骨折愈合良好。椎体内应用自体海绵没有任何有益的效果。这项技术现在可用于临床；因此，它提供了一个机会，以消除水泥相关的并发症。
Introduction. Current treatment strategies for osteoporotic vertebral compression fractures (VCFs) focus on cement-associated solutions. Complications associated with cement application are leakage, embolism, adjacent fractures, and compromise in bony healing. This study comprises a validated VCF model in osteoporotic sheep in order to (1) evaluate a new cementless fracture fixation technique using titanium mesh implants (TMIs) and (2) demonstrate the healing capabilities in osteoporotic VCFs. Methods. Twelve 5-year-old Merino sheep received ovariectomy, corticosteroid injections, and a calcium/phosphorus/vitamin D-deficient diet for osteoporosis induction. Standardized VCFs (type AO A3.1) were created, reduced, and fixed using intravertebral TMIs. Randomly additional autologous spongiosa grafting (G1) or no augmentation was performed (G2, n = 6 each). Two months postoperatively, macroscopic, micro-CT and biomechanical evaluation assessed bony consolidation. Results. Fracture reduction succeeded in all cases without intraoperative complications. Bony consolidation was proven for all cases with increased amounts of callus development for G2 (58.3%). Micro-CT revealed cage integration. Neither group showed improved results with biomechanical testing. Conclusions. Fracture reduction/fixation using TMIs without cement in osteoporotic sheep lumbar VCF resulted in bony fracture healing. Intravertebral application of autologous spongiosa showed no beneficial effects. The technique is now available for clinical use; thus, it offers an opportunity to abandon cement-associated complications.