Minimum cement volume for vertebroplasty
Minimum cement volume for vertebroplasty
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DOI：
10.1007/s00264-014-2620-7
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发表时间：
2015-04-01
影响因子：
2.7
通讯作者：
Vengust, Rok
中科院分区：
文献类型：
--
作者：
Martincic, David;Brojan, Miha;Vengust, Rok
目的经皮椎体成形术是一种广泛应用的椎体强化技术。这是一种微创和低风险的手术，但有一些缺点，骨水泥泄漏和相邻椎骨骨折的数量相对较高。本尸体研究的目的是确定椎体成形术中骨水泥填充体积的最小百分比，以恢复椎体刚度和相邻的intradiscalpressure.Methods 13胸腰椎移动的节段被加载，以诱导椎体骨折。骨折后行椎体成形术，同一骨折椎体4次。注入的骨水泥体积为骨折椎体体积的5%，以达到骨水泥填充的5%、10%、15%和20%。结果椎体骨折后压缩刚度降低至骨折前的47%，填充10%骨水泥后压缩刚度部分恢复至骨折前的61%。随着椎体成形术椎间盘内压力逐渐增加，这取决于标本的位置，从48%到71%，在15%的骨水泥fill.Conclusions压缩刚度和椎间盘内压力增加骨水泥填充的百分比。15%的骨水泥填充是极限，超过该极限，压缩刚度或椎间盘内压力不会显著增加，并且是我们推荐用于椎体成形术的最小骨水泥体积。在平均胸腰椎中，这意味着4-6 ml骨水泥。
Purpose Percutaneous vertebroplasty is a widely used vertebral augmentation technique. It is a minimally invasive and low-risk procedure, but has some disadvantages with a relatively high number of bone cement leaks and adjacent vertebral fractures. The aim of this cadaveric study was to determine the minimum percentage of cement fill volume in vertebroplasty needed to restore vertebral stiffness and adjacent intradiscal pressure.Methods Thirteen thoracolumbar spine mobile segments were loaded to induce a vertebral fracture. After fracture vertebroplasty was performed, four times in the same fractured vertebra. The injected cement volume was 5 % of the fractured vertebral volume to reach 5, 10, 15 and 20 % of cement fill. Biomechanical testing was performed before the fracture, after the fracture and after each cement injection.Results After vertebral fracture compressive stiffness was reduced to 47 % of the pre-fracture value and was partially restored to 61 % after 10 % cement fill. With vertebroplasty intradiscal pressure gradually increased, depending on specimen position, from 48 to a total of 71 % at 15 % of cement fill.Conclusions Compressive stiffness and intradiscal pressure increase with the percentage of cement fill. Fifteen per cent of cement fill was the limit beyond which no substantial increase in compressive stiffness or intradiscal pressure could be detected and is the minimum volume of cement we recommend for vertebroplasty. In the average thoracolumbar vertebra this means 4-6 ml of cement.