椎体成形术或后凸成形术生物活性充填材料的体内降解

目的 观察磷酸钙骨水泥(CPC)和硫酸钙骨水泥(CSC)在椎体内的演变过程,为椎体成形术或后凸成形术中寻找更为合适的充填材料.方法 对24只成年雌性绵羊的L2～L5椎体制作骨缺损,随机注入CPC、CSC和聚甲基丙烯酸甲酯(PMMA),其中剩余的椎体作为空白对照,并以L6椎体作正常对照.术后2周、12周和24周分别随机处死其中8只绵羊,进行大体观察、生物力学测试、不脱钙组织学分析.结果 CSC组和CPC组椎体被填充材料明显增强,但CSC组椎体力学性能自2～12周呈现下降趋势,而到24周时又出现回升.CPC组椎体力学性能自2～24周呈上升趋势.12周时3组新骨形成量差异不明显,CSC已被大部分吸收;植入24周时新骨形成量CSC组＞空白组＞CPC组,CPC出现了明显的吸收,而CSC仅有少量残留.结论 CSC与CPC初期均能明显增强椎体;随着时间的推移,CSC在体内降解迅速,而CPC在体内降解缓慢.

The degradation of bioactive bone cement for vertebroplasty or kyphoplasty in vivo

Objective To observe the degradation of calcium phosphate cements (CPC) and calcium sulfate cement (CSC) in vertebras, and explore the ideal filler for vertebroplasty and kyphoplasty.Methods Bone voids were created in L2-L5 vertebras of 24 female mature sheep. CPC, CSC and polymethylmethacrylate (PMMA) were injected into one bone void randomly, and the remaining voids served as the blank control, and L6 vertebra served as the normal control. Eight sheep were sacrificed at the 2nd,12th and 24th week after operation randomly. Gross observation, biomechanical test and undecalcified bone histology analyses were performed. Results Biomechanical analysis showed that the vertebras could be augmented by CPC and CSC. The mechanical properties of CSC group were decreased from the 2nd to 12th week, and increased from the 12th to 24th week after operation. The mechanical properties of CPC group were increased from the 2nd to 24th week, however, but lower than PMMA group. Histology analysis revealed CSC was mostly absorbed at the 12th week, and the bone voids were repaired only in large part at the 24th week. CPC was absorbed partly at the 24th week, and new bone was formed in contact with the surface of the CPC. Conclusion The vertebras can be augmented instantly by CPC and CSC. As time went on, CSC was absorbed fast and CPC was absorbed very slowly.