骨水泥和纳米骨浆强化椎弓根螺钉植入固定骨质疏松椎体的生物力学特点

背景：纳米骨浆和骨水泥注入是强化椎弓根螺钉固定的两种常用方法，但目前关于两种加强方法的强化效果比较的报道相对较少。 目的：对比骨水泥或纳米骨浆强化椎弓根螺钉植入固定骨质疏松椎体的生物力学特点。 方法：取24个人尸体椎弓根，均符合骨质疏松标准，随机均分为3组，对照组仅植入椎弓根螺钉，骨水泥组在钉道内注入骨水泥后植入椎弓根螺钉，纳米骨浆组在钉道内注入纳米骨浆后植入椎弓根螺钉。植入2 h后，检测各组标本最大轴向拔出力和最大旋出力矩。 结果与结论：骨水泥组、纳米骨浆组的最大轴向拔出力和最大旋出力矩均大于对照组(P < 0.05)，并且骨水泥组的最大轴向拔出力和最大旋出力矩大于纳米骨浆组(P < 0.05)。表明骨水泥和纳米骨浆强化可有效提高椎弓根螺钉植入固定骨质疏松椎体的最大轴向拔出力和最大旋出力矩，且骨水泥强化效果更明显。 中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Bone cement and nano bone putty strengthen pedicle screw implantation in the fixation of osteoporotic vertebral body: biomechanical characteristics

BACKGROUND: Nano bone putty and bone cement injection are two common methods to strengthen the fixation of pedicle screws, but there are relatively few reports on the comparison of their strengthening effects. OBJECTIVE: To compare the biomechanical characteristics of bone cement and nano bone putty strengthening pedicle screw implantation in the fixation of osteoporotic vertebral body. METHODS: Totally 24 human cadaveric pedicles were obtained, which were all in line with osteoporosis standards, and randomly divided into 3 groups: control group (only implanted pedicle screws), bone cement group (first injected bone cement in the nail channel, and then implanted pedicle screws) and nano bone putty group (first injected nano bone putty in the nail channel, and then implanted pedicle screws). After 2 hours of implantation, the maximum axial pullout strength and the maximum rotation torque of specimens in each group were determined. RESULTS AND CONCLUSION: The maximum axial pullout strength and maximum rotation torque of the bone cement and the nano bone putty groups were greater than those of the control group (P < 0.05), and the      maximum axial pullout strength and the maximum rotation torque of the bone cement group were greater than those of the nano bone putty group (P < 0.05). These results demonstrate that the maximum axial pullout strength and the maximum rotation torque of pedicle screw implantation in the fixation of osteoporotic vertebral body can be effectively improved by injection of bone cement and nano bone putty, and the strengthening effect of bone cement is more obvious.