Radiopacity and fatigue characterization of a novel acrylic bone cement with sodium fluoride

Acrylic bone cement must provide good radiographic visibility and good long-term mechanical resistance in joint replacements. A new formulation of cement with 6% barium sulfate and 6% sodium fluoride was developed (Fluoride Bone Cement). Barium sulfate is a necessary addition to allow radiographic visibility although it reduces the mechanical strength of the material. Sodium fluoride promotes bone formation. However, its effect on the mechanical behavior is currently unknown while its influence on radiopacity can only be roughly estimated. The aim of this investigation was to establish if the new formulation would be suitable for clinical trials. In this respect, a mechanical (fatigue test) and radiographic (optical density measurements on x-ray films) characterization was performed on a typical commercially available cement with barium sulfate added and on the Fluoride Bone Cement. It was demonstrated that the fluoride cement has a (marginally) superior fatigue strength and comparable radiopacity to commercial radiopaque cements.     

椎体成形术中高黏度骨水泥渗漏分析

目的了解高黏度骨水泥在椎体成形术中的渗漏率、渗漏部位及其临床疗效等相关问题。方法回顾性分析本院自2013-06—2014-09行高黏度骨水泥经皮椎体成形术42例的影像资料及临床病例,分析研究手术前后腰背部疼痛VAS评分,骨水泥渗漏部位及相关并发症等。结果患者术后24 h疼痛均明显缓解,视觉疼痛模拟评分(VAS)明显改善(P0.05),10例13个椎体(22.81%)出现骨水泥渗漏,椎体周围渗漏发生率(46.15%)最高,均未出现明显临床症状及体征。结论高黏度骨水泥能确切改善患者疼痛症状,渗漏率相对较低,且多无明显临床症状,适合临床应用。     

The clearance of Gentamicin from antibiotic-loaded bone cement

Summary The concentrations of Gentamicin in the serum, drainage fluid and urine were determined by radioimmunoassay in 40 patients after total hip replacement and 10 after knee replacement. Palacos R bone cement with added Gentamicin had been used to fix the prostheses in all cases. Two types of response were observed; in Group I the Gentamicin levels rose very rapidly, whereas in Group II a more gradual increase was seen. In all cases the level of Gentamicin had fallen to a negligible amount by the fifth day after operation.

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Résumé La concentration de la Gentamycine dans le sérum, le liquide de drainage et l'urine a été déterminée par dosage radioimmunologique chez 40 malades après arthroplastie totale de la hanche et chez 10 malades après le arthroplastie du genou. Le ciment Palacos R additionné de Gentamycine a été employé dans chaque cas pour fixer la prothèse. Deux sortes réactions ont été observées: dans le premier groupe le taux de Gentamycine s'est élevé très rapidement, tandis que dans le second groupe l'élévation a été plus progressive. Dans chaque cas le taux de Gentamycine était tombé à un niveau négligeable dès le cinquième jour après l'opération.

     

骨水泥对血液流变学影响的实验研究

目的通过动物实验研究探讨骨水泥对血液流变学变化的影响。方法将24只新西兰白兔随机分为两组试验组和对照组,每组12只,试验组股骨髓腔内填充骨水泥而对照组不填充骨水泥,术前、术后10min、1h、3h、24h采集颈内静脉血,测定血液流变学指标,用SPSS17．0统计学软件将结果进行统计学分析。结果手术前后血液流变学指标改变有统计学差异（P〈0．05）,而实验组与对照组则无统计学差异（P〉0．1）。结论骨水泥对术后24h内兔血液流变学变化无显著影响。     

椎体成形术中骨水泥弥散分布等级的量效关系

目的 提出椎体成形术骨水泥弥散等级分级理论,对不同等级下的止痛效果、腰椎功能进行评价.方法 收集椎体成形术患者57例,根据正侧位X线片简便判断出骨水泥分布等级并进行分组,对术前、术后1周、术后3个月各组间止痛效果、腰椎功能障碍指数进行比较.结果 57例获得平均7个月的随访.57例中14例出现椎体周围骨水泥外渗的情况,未出现神经症状或原有症状加重,每个椎体内注入骨水泥量1.5～5.0(2.6±1.1)ml,57例根据骨水泥弥散等级分为3组,VAS、ODI评分各组内术后与术前比较差异有统计学意义(P＜0.001);术后1周、3个月的组间VAS评分差异无统计学意义(P＞0.05),但在术后1周1级组与3级组ODI评分差异有统计学意义(P ＜0.05);而3个月后各组间ODI评分差异无统计学意义(P＞0.05).结论 经皮椎体成形术(PVP)各级骨水泥弥散等级均可有效缓解椎体压缩骨折引起的疼痛,疼痛缓解程度与骨水泥弥散程度不成比例关系;但在椎体成形术后早期骨水泥弥散等级对脊柱功能障碍指数影响存在统计学意义,认为该分级方法对PVP术后早期脊柱功能评价存在临床指导意义.     

Comparison and optimization of three centrifugation systems for reducing porosity of Simplex P bone cement

Simplex P bone cement was spun for 30, 60, and 120 seconds in three different centrifugation systems (I.E.C. HN-S II, I.E.C. clinical, and Johnson & Johnson) to determine whether differences among the three systems also produce differences in the improvement of the fatigue strength of the cement. The fatigue properties of the cement after centrifugation were also assessed when it was mixed with monomer that had been chilled to 0 degrees C. There were important and statistically significant differences in the fatigue life of Simplex P spun for the same duration in the different centrifuges. Simplex P prepared as recommended by the manufacturer had an average fatigue life of 15,143 cycles in the test system used. Optimum centrifugation among the techniques studied increased the fatigue life nearly fivefold, to the range of 71,000 cycles. Taking into account both the fatigue strength and the viscosity of the cement, the optimum centrifugation system for improving the fatigue life of Simplex P bone cement is the Miller cartridge containing two packs of cement spun in the IEC-HN-S II centrifuge. The authors recommend 30 seconds of centrifugation if the monomer is not chilled prior to mixing and 60 seconds if the monomer is chilled.     

椎体成形术中骨水泥靶向封填及二次推注技术的临床应用

目的:观察椎体成形术中高粘度骨水泥靶向封填、低粘度骨水泥二次推注技术在骨折线累及椎体边缘中的应用效果。方法:选取2019年1月至2021年9月因骨质疏松性椎体压缩性骨折行椎体成形术治疗的老年患者作为筛选对象,通过相关标准及进一步CT检查筛选出56例存在骨折线累及椎体前壁或上下终板者纳入研究。其中男21例,女35例,年龄67~89(76.58±9.68)岁;56例患者术中均进行了骨水泥二次推注。首次推注仅用少量高粘度骨水泥对椎体边缘裂口进行靶向封填,二次推注时应用低粘度骨水泥均匀注满椎体。记录手术时间、骨水泥用量、骨水泥渗漏情况,采用视觉模拟评分(visual analogue scale,VAS)评估疼痛缓解情况。结果:所有患者顺利完成手术,手术时间(50.41±10.30)min,骨水泥注入量(3.64±1.29)ml;56例病例获得了3个月以上随访。术前VAS为(7.21±2.41)分,术后3 d降低为(2.81±0.97)分(P<0.05)。56例患者中2例(3.57%)发生骨水泥渗漏,其中1例向椎旁静脉渗漏,1例在封堵椎体裂口时通过裂口向椎旁轻度渗漏,2例患者均无明显临床症状。结论:在椎体成形术中对于存在椎体前壁或终板破裂者,可采用高粘度骨水泥靶向封填、低粘度骨水泥二次推注技术以减少术中骨水泥渗漏发生,提高手术安全性。     

骨水泥弥散类型对治疗骨质疏松性椎体压缩骨折的影响

目的:观察PVP、PKP及手法复位PVP术后不同骨水泥弥散类型构成及其对老年骨质疏松性椎体压缩骨折治疗效果和骨水泥渗漏率的影响。方法:对2012年1月至2015年1月采用单侧经皮椎体成形术治疗的老年骨质疏松性椎体压缩骨折病例进行回顾性分析,其中PVP术式56例,男22例,女34例,年龄60~78岁;PKP术式48例,男17例,女31例,年龄61~79岁;手法复位PVP术式43例,男15例,女28例,年龄60~76岁。术后摄正侧位DR片,以Auto CAD图形处理软件计算椎体内骨水泥弥散区面积和团块区面积,然后计算正侧位DR片平均弥散区与平均团块区面积的比值(K),定义K50%为团块型,50%≤K≤100%为混合型,K100%为弥散型。分析不同椎体成形术式骨水泥弥散类型构成,然后按骨水泥弥散类型分为弥散型、混合型和团块型3组,观察各类型组的视觉模拟评分(VAS)、椎体压缩率、JOA评分以及骨水泥渗漏率等并进行统计学分析。结果:所有患者获得随访,时间为12~24个月,平均17.2个月。PVP及PKP和手法复位PVP 3种术式的骨水泥弥散类型构成不同(P0.05),PVP术式弥散型、混合型、团块型构成比分别为46.43%、35.71%和17.86%,PKP术式为16.67%、37.50%和45.83%,手法复位PVP术式为37.21%、44.19%和18.60%。PVP术式以及手法复位PVP术式以弥散型和混合型构成为主,而PKP术式以团块型和混合型构成为主。VAS评分及JOA评分以及骨水泥渗漏率3种弥散类型术后组间比较差异均无统计学意义。椎体压缩率:3种弥散类型术后比较差异有统计学意义(P0.05),弥散型组术后24 h和末次随访时分别为(17.31±5.06)%和(18.58±4.91)%,混合型组为(14.21±5.15)%和(14.59±5.07)%,团块型组为(13.89±5.02)%和(14.28±4.94)%。结论 :PVP及PKP和手法复位PVP 3种不同术式骨水泥弥散类型构成不同,且团块型与混合型弥散方式较弥散型能更好地恢复压缩椎体的高度,而不同骨水泥弥散方式的中早期疗效差异不明显。     

Use of a biphasic cement bone substitute in the management of metaphyseal fractures

ObjectivesIn recent years, the increase in utilisation of bone substitutes in the reconstruction of bone defects has been fuelled by donor site complications associated with autologous bone harvesting. However the ability of bone substitute to stimulate bone union while maintaining fracture reduction has been a topic of debate. Cerament Bone Void Filler (CBVF) is a novel biphasic and injectable ceramic bone substitute that has high compressive strength and the ability to promote cancellous bone healing.Materials and MethodThis is a retrospective study to evaluate the surgical outcome of utilising CBVF in the treatment of depressed metaphyseal bone fractures over a two year period. The patients were followed up for at least six months after surgery and clinical parameters such as wound site complications were collated. Radiographic imaging was evaluated to determine loss of fracture reduction and rate of cement resorption.ResultsThirteen patients with depressed metaphyseal fractures were enrolled, which included: (i) one proximal humerus fracture; (ii) three tibial plateau fractures; and (iii) nine calcaneal fractures. None of the patients showed significant collapse in fracture reduction after six months of follow up. Cement resorption was noted in one patient as early as three weeks after surgery. There were no cases of cement leak or wound site complications.ConclusionCerament Bone Void Filler (CBVF) is a promising bone graft substitute in the management of depressed metaphyseal bone fractures, with the ability to maintain fracture reduction despite cement resorption.     

不同温度保存单体在不同环境温度下聚合的骨水泥抗疲劳性能比较

目的使用不同温度下保存的单体,在不同环境温度下骨水泥聚合,测试真空搅拌制成的骨水泥模块的抗疲劳性能,探讨保存单体的最佳温度及骨水泥聚合环境的最佳温度。方法骨水泥单体放置在21℃、4℃的环境,在室温21℃条件下,与粉末真空搅拌1min并放置3min后,用骨水泥枪将其分别注入21℃、50℃相同的金属模具内,骨水泥聚合后取出骨水泥模块。分成四组,1组:骨水泥21℃,金属模具21℃;2组:骨水泥21℃,金属模具50℃;3组:骨水泥4℃,金属模具21℃;4组:骨水泥4℃,金属模具50℃,每组各21个骨水泥模块。在环境温度37℃、湿度100%的试验条件下,将骨水泥模块放置在37℃水槽内。用MTS力学试验机,应用完全逆转的张力压力疲劳循环法,测试力为15MPa,负荷频率是2Hz。测试力大约是体内骨水泥应力水平的3.5倍。标本载荷直至断裂,记录循环次数。去除少于5000次失败的标本,应用两独立样本t检验比较各组的疲劳循环次数。结果21℃条件下的骨水泥和金属模块为标准组(1组),其疲劳循环次数较2、3和4组为低,差异均有统计学意义(P≤0.001)。结论在室温21℃下真空搅拌相同温度保存的单体并于相同温度模具下制作的骨水泥模块,其抗疲劳性能最差。单体与聚合环境温度相差20℃￣30℃,骨水泥模块的抗疲劳性能明显增强。     

髋关节置换术中骨水泥植入后对老年患者血流动力学的影响

目的 探讨骨水泥型髋关节置换术中骨水泥植入后对老年患者血流动力学的影响.方法 2008年1月至2009年4月共对50例老年股骨颈骨折或股骨头坏死患者行骨水泥型髋关节置换术,男22例,女28例;年龄70～92岁,平均83.2岁.关节置换原因:股骨颈骨折46例,股骨头骨折术后股骨头坏死4例.比较患者骨水泥植入前和植入后1、2、3、4、5、6、7、8、9、10 min的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率、血氧饱和度(SPO2)等数据.结果 术后所有患者血压均有不同程度下降,骨水泥植入后1 min血压开始下降,2～6 min血压下降最为显著,与骨水泥植入前比较差异均有统计学意义(SBP,DBP:P<0.05),7 min开始回升,10 min基本恢复正常.SPO2下降明显,平均从99.65%±0.35%下降至92.80%±1.08%(P<0.05).心率无明显变化,差异无统计学意义(P>0.05).结论 髋关节置换术中骨水泥植入后对老年患者血流动力学影响显著.     

骨水泥的分布与剂量对椎体成形术疗效影响的研究

目的 在使用经皮椎体成形术(PVP)治疗脊柱胸腰段(T11～L2)骨质疏松性椎体压缩骨折(OVCFs)中,探讨骨水泥的分布和剂量对患者术后止痛效果的影响.方法 选取自2010-01-2012-12行PVP手术的673例,用VAS评分对患者在术前、离院时、术后3个月和术后1年进行随访,按照最终的VAS评分结果,将患者分为A组(0～3分)和B组(＞4分),比较2组间骨水泥分布情况和注射剂量.结果 673例中622例均获得1年的随访,VAS评分在术前、离院时、术后3个月和术后1年分别为(9.2±0.06)分、(1.4±0.03)分、(1.7±0.04)分和(1.8±0.08)分.其中A组521例,骨水泥注射剂量为3.2～8.0 (5.1±0.05) ml;B组101例,骨水泥为3.0～6.5 (4.7±0.06)ml,差异无统计学意义(t=0.80,P=0.34).术后影像学发现骨水泥在A组中的分布比B组在椎体的前柱左右更对称,并且在上下终板间的椎体前缘有连续的骨水泥填充.结论 PVP是治疗老年OVCFs的一种简单快速、疗效确实的手术方法;达到骨水泥满意的分布状态是提高手术疗效的关键,而与具体的用量无关.     

抗生素骨水泥柱占位联合植骨治疗股骨远端开放骨折骨缺损的疗效分析

目的: 探讨抗生素骨水泥柱占位联合髂骨植骨在股骨远端开放骨折骨缺损治疗中的有效性及初步疗效。方法: 回顾性分析2014年10月至2021年3月采用抗生素骨水泥柱占位联合髂骨植骨技术治疗股骨远端开放骨折骨缺损16例,其中男12例,女4例;年龄28~68岁。车祸伤11例,高处坠落伤5例,Gustilo分型Ⅰ型3例,Ⅱ型5例,ⅢA型8例。采用AO分型:C2型9例,C3型7例。从受伤至接受最终植骨手术时间为4~119 d。骨缺长损度2~10 cm。记录患者骨折愈合时间、并发症、膝关节功能Merchan评分。结果: 本组16例患者均获得随访,随访时间9~29个月。16例患者切口均Ⅰ期愈合,无术后感染、钢板断裂、肢体短缩及膝内外翻畸形等并发症。骨折愈合时间为4~10个月。膝关节功能根据Merchan评分标准评估,优8例,良4例,可3例,差1例。结论: 采用抗生素骨水泥柱占位联合髂骨植骨治疗股骨远端开放复杂骨折骨缺损有助于预防感染、协助骨折复位,增加固定强度,减少植骨量,是一种有效的手术方式。     

骨水泥振动器的研制及其对骨水泥-骨界面影响的实验研究

目的 评价骨水泥振动器对提高骨水泥-骨界面微嵌合强度的效果及临床意义.方法 取新鲜成猪股骨100根,随机分成6组;力学测试组:抗拉力实验组(A1)与对照组(A2)和抗压力实验组(B1)与对照组(B2)模型每组各20个;影像学测试组:实验组(C1)与对照组(C2)模型各10个.对模型进行力学及影像学检测,比较实验组与对照组骨水泥-骨界面的微嵌合强度.结果 力学及影像学测定显示实验组骨水泥-骨界面微嵌合强度均高于对照组,二者比较差异具有显著统计学意义(P＜0.01).结论 骨水泥振动器能显著提高骨水泥-骨界面微嵌合强度,对于减少人工假体远期无菌性松动具有一定的意义.     

载双磷酸盐骨水泥的静态机械强度和疲劳极限

目的:研究载双磷酸盐骨水泥的疲劳极限和静态机械强度及相关影响因素.方法制备不同载荷的载双磷酸盐纯粉骨水泥试件,根据纯粉载荷及试件的贮存环境进行分组,检测抗压强度、压缩弹性模量、抗张强度、抗弯强度和疲劳极限,威布尔频率函数分析疲劳极限,激光散射法测定双磷酸盐纯粉的粒径.结果:增加纯粉载荷可提高试件的抗压强度极限、抗张强度极限,降低疲劳极限.体液浸泡可降低试件的抗压强度极限、压缩弹性模最、抗张强度极限及疲劳极限.结论:双磷酸盐纯粉的粒径及分布范围较小,载入后丙烯酸骨水泥的静态机械强度高于美国材料实验协会/国际标准化组织标准,但疲劳极限有一定程度下降.与文献报道双磷酸盐的液剂或片剂磨粉相比,纯粉对骨水泥疲劳极限和静念机械强度的影响最小.     

经皮椎体成形术中骨水泥对老年骨质疏松症患者凝血功能的影响

目的 观察经皮椎体成形术(PVP)中骨水泥对老年骨质疏松症患者凝血功能的影响.方法 于椎弓根穿刺前10 min、注入骨水泥后1、20 min、2 h分别抽血检测11例患者的凝血功能相关指标,包括血浆凝血酶原时间(PT)、活化的部分凝血酶原时间(APTT)、血浆纤维蛋白原(FIB)和鱼精蛋白副凝固实验(3P实验),并汇总数据进行统计学分析.结果 PVP中骨水泥注入后20 min,PT缩短、FIB增高、3P实验阳性率升高(P<0.05),骨水泥注入2 h后基本恢复至注入前水平.除1例患者PTA术后2 h稍高于正常值(126%),其余患者各个时间点的各项指标均在正常参考值范围内.结论 PVP术中注入骨水泥对于凝血功能正常的患者基本安全,但在注入后会产生一过性轻微的高凝倾向.     

椎体成形术中不同骨水泥容量及位置的生物力学评估

目的利用有限元实体模型来评价植入不同骨水泥的量与部位,以及椎体成形术后椎体的应力分布。方法本研究分为两部分,首先是采用患者的计算机断层影像资料建立L1椎体的三维有限元模型,根据文献中椎体力学测试的力-变形曲线推算出骨质疏松症及骨折后的材料参数。然后分析骨质疏松症椎体、骨折后椎体以及椎体成形术中椎体植入骨水泥后的力学变化,探讨骨水泥的容量、位置对椎体蒙马氏应力及刚度的关系。第二是建立一个五节椎体模型来评价椎体成形术对邻近椎体的影响。结果分析结果得知,椎体植入骨水泥的容量越多,刚度增加越多;单侧(左侧、右侧、中间)与双侧植入骨水泥在同一植入骨水泥容量下差异无显著性意义(P>0.05)。结论若骨折后能矫正恢复原来的外形,则对邻近节段的影响并不大。     

下腔静脉过滤器对骨水泥植入综合征的预防作用研究

目的 研究下腔静脉过滤器(rvcr)对骨水泥植入综合征(BCIS)的预防作用. 方法雄性绵羊10只,体质量25～30 kg,随机分为A组(不植入IVCF)和B组(植入IVCF)(n=5).麻醉后B组绵羊先在1250 mA透视机透视下,由颈内静脉经右心房在.肾下极5 cm处下腔静脉内植入IVCF.后将两组绵羊离断股骨颈扩髓腔,植入10 mL骨水泥,并逐渐增加髓腔内压,同期观测血压、心率、中心静脉压(CVP)和血气变化,心前区超声心动图动态实时显示心腔内情况改变.术毕分离肺脏,油红染色观察肺组织病理变化.结果 A组绵羊植入骨水泥后,当将股骨髓腔压力增加至120mm Hg时,右心房、右心室内即出现了点状不均匀回声,且随髓腔压力继续增加,点状回声变成大量雪花状叫声影,并伴血压、PaO2明显下降,25 min后收缩压下降至(80±11)mm Hg(P＜0.01),Pa02降至最低(P＜0.05),而心率、CVP进行性升高,血气分析示呼吸性酸中毒合并代谢性酸中毒,病理提示肺动脉血管内广泛散布大量脂肪栓子,血管腔阻塞;而B组绵羊在植入骨水泥后,在股骨髓腔内压升至400 mm№时尚未观察到右心腔出现脂肪栓子回声影,且血压、PaO2、心率、CVP较植入前未见明显降低或升高(P＞0.05),血气分析结果示通气正常,肺组织脂肪油红染色阴性. 结论 IVCF可有效预防骨水泥植入而引起的BCIS的发生.     

Comparison of CT characteristics of extravertebral cement leakages after vertebroplasty performed by different navigation and injection techniques

Summary   Objective. This study was intended to assess the results of post-operative CT scans in three groups of patients following percutaneous vertebroplasty (VP) using different navigation and injection methods, in an attempt to explain the radiological characteristics of extravertebral cement leakage with relation to needle placement and focused on the ventral epidural accumulation of bone cement. Furthermore, we have suggested a morphological (and functional) classification of the types of cement leakage. Methods. Between July 2001 and February 2005, 123 percutaneous VP procedures were performed during 75 sessions in 65 patients for treatment of painful osteoporotic vertebral body compression fractures. These included:- Group I: 28 patients, 33 sessions; 50 right sided unilateral VP under fluoroscopic control with central position of the tip of the needle within the bone marrow. Group II: 27 patients, 28 sessions; 50 bilateral VP under fluoroscopic control with separate cement injections into both “hemivertebrae”. Group III: 14 patients, 14 sessions; 23 bilateral VP navigated by frameless stereotaxy (neuronavigation). Needles were positioned strictly into the lateral thirds of the vertebral bodies. Leakages were classified as epidural, foraminal, intradiscal, venous paravertebral, compact extravertebral on the post-operative CT scans, and their frequency was compared in relation to the navigation method and the position of the tip of the needle. Results. Group I: extravertebral cement was detected in 23 patients (82%), and in 35 (70%) of the 50 vertebrae treated (ventral epidural: 23 vertebrae = 46%; intradiscal: 12 vertebrae = 24%; venous paravertebral: 8 vertebrae = 16%; intraforaminal: 7 vertebrae = 14%; and compact extravertebral: 3 vertebrae = 6%). Group II: extravertebral cement was detected in 20 patients (74%), and in 38 (76%) of the 50 vertebrae treated (ventral epidural: 12 vertebrae = 24%; intradiscal: 12 vertebrae = 24%; venous paravertebral: 9 vertebrae = 18%; and foraminal: 1 vertebra = 2%). Group III: extravertebral cement could be detected in 10 patients (71%), and in 10 (43%) of the 23 vertebrae treated (ventral epidural: 3 vertebrae = 13%; intradiscal: 8 vertebrae = 34%; venous paravertebral: 4 vertebrae = 17%). Conclusion. The incidence of epidural accumulation of bone cement may be concluded to be closely correlated with the position of the tip of the needle. Centrally injected bone cement may easily invade into the basivertebral system, and the material can then be transferred via these veins toward the ventral epidural space, and result in canal compromise and/or compression of the neural elements. The results of statistical analysis (Chi-square test) revealed that injection of bone cement into the lateral third of the vertebral body significantly decreases the extent of ventral epidural leakage. Therefore, a strictly lateral injection is advised, when the tip of the needle is placed into the lateral third of the vertebral body. Frameless stereotaxy navigation improves achievement of accurate needle placement and decreases the frequency of ventral epidural leakage. It is a safe and very accurate method for positioning of the injecting needles. Correspondence: Prof. Dr. Tamás Dóczi, Department of Neurosurgery, University of Pécs, 7623 Pécs, Rét u. 2., Hungary.     

基于Mimics软件计算椎体强化术后椎体内骨水泥体积及骨水泥/椎体体积比的新方法

目的:建立基于Mimics软件计算椎体强化术后椎体内骨水泥量与骨水泥/椎体体积比的新方法,并验证其准确性与可靠性.方法:2012年1月～3月共有12例骨质疏松性椎体压缩骨折患者在我院接受椎体强化术(14个椎体),均使用标准化定量推注管道注入骨水泥,由2名脊柱外科医师准确记录骨水泥量,将他们记录的平均值定义为椎体内实际骨水泥量.术后对患者手术节段进行CT薄层扫描,再将CT数据输入Mimics软件,利用Mimics软件计算测量注入椎体的骨水泥量及椎体体积,并计算出椎体内骨水泥/椎体的体积比,将2名检测者计算出的骨水泥量平均值定义为椎体内骨水泥估计量,将计算出的椎体内骨水泥估计量与椎体内实际骨水泥量进行对比分析,判断这一新方法的准确性.并对2名不同检测者按照同样操作流程测量出的骨水泥体积及椎体体积进行比较,以判断这一新方法的可靠性.结果:12例患者(14个椎体)手术均顺利完成,术中未见明显骨水泥渗漏,2名医师记录的椎体内实际骨水泥量为4.99±0.60ml,检测者A测量出的骨水泥体积和椎体体积分别为5.01±0.61ml、26.66±2.93ml,检测者B测量出的骨水泥体积和椎体体积分别为5.02±0.59ml、26.64±2.92ml,检测者A及B测量出骨水泥体积的平均值(椎体内骨水泥估计量)为5.02±0.60ml,椎体内骨水泥/椎体体积比为0.19±0.03(0.13～0.23).椎体内骨水泥估计量与椎体内实际骨水泥量相比无显著性差异(P＞0.05),骨水泥估计量及椎体体积计算量在2名不同检测者之间也无显著性差异(P＞0.05).结论:Mimics软件可精确计算椎体内骨水泥量,并测量出骨水泥/椎体体积比,这一方法具有较好的准确性及可靠性,有利于进一步开展椎体强化术骨水泥量的相关研究.