中国组织工程研究 ›› 2014, Vol. 18 ›› Issue (16): 2487-2492.doi: 10.3969/j.issn.2095-4344.2014.16.005

• 组织工程骨及软骨材料 tissue-engineered bone and cartilage materials • 上一篇    下一篇

骨填充网袋修复椎体压缩骨折的生物力学变化

刘训伟1,孔小燕2,钟 建3,杨文州2,魏岱旭3,彭湘涛1,叶 勇1,杜艳霞1,孙 钢1   

  1. 1解放军济南军区总医院医学影像科,山东省济南市 250031;2山东冠龙医疗用品有限公司,山东省济南市 250101;3纳米技术及应用国家工程研究中心,上海市 200241
  • 修回日期:2014-02-03 出版日期:2014-04-16 发布日期:2014-04-16
  • 通讯作者: 孙钢,主任医师,博士,教授,博士生导师,解放军济南军区总医院医学影像科,山东省济南市 250031
  • 作者简介:刘训伟,男,1975年生,山东省菏泽市人,泰山医学院毕业,主治医师,主要从事介入诊疗和影像诊断研究。

Bone filling mesh container repairs vertebral compression fractures: biomechanical changes

Liu Xun-wei1, Kong Xiao-yan2, Zhong Jian3, Yang Wen-zhou2, Wei Dai-xu3, Peng Xiang-tao1, Ye Yong1,  Du Yan-xia1, Sun Gang1   

  1. 1Medical Image Department of General Hospital of Jinan Military Region, Jinan 250031, Shandong Province, China; 2Shandong Guanlong Medic Utensils Co., Ltd., Jinan 250031, Shandong Province, China; 3National Engineering Research Center for Nanotechnology (NERCN), Shanghai 200241, China
  • Revised:2014-02-03 Online:2014-04-16 Published:2014-04-16
  • Contact: Sun Gang, M.D., Professor, Chief physician, Doctoral supervisor, Medical Image Department of General Hospital of Jinan Military Region, Jinan 250031, Shandong Province, China
  • About author:Liu Xun-wei, Attending physician, Medical Image Department of General Hospital of Jinan Military Region, Jinan 250031, Shandong Province, China

摘要:

背景:经皮椎体成形、经皮椎体后凸成形是治疗椎体压缩性骨折的主要手段,存在骨水泥外溢,引起椎管狭窄、神经受压、肺栓塞、引起伤椎再骨折等问题。

目的:验证以聚对苯二甲酸乙二酯材料制备的骨填充网袋应用于椎体压缩骨折的可行性。
方法:按GB/T16886相关部分的试验方法规定检测骨填充网袋的生物学性能;检测骨填充网袋老化前后承受拉力的能力;向骨填充网袋内灌注骨水泥并测压,观察骨填充网袋膨胀抬升及骨水泥渗出情况。向新鲜猪椎体直接注入骨水泥或置入骨填充网袋后再灌注骨水泥,测试椎体的刚度及强度。向4月龄猪腰椎内置入骨填充网袋后再灌注骨水泥,定期观察椎体内骨组织生长情况。

结果与结论:生物学性能检测表明骨填充网袋具有良好的生物相容性。骨填充网袋老化前后具有相近的力学强度,说明其可长期保持强度性能稳定。大气环境下,骨填充网袋在灌注骨水泥压力为5-10 atm时呈球形膨胀,能起到抬升作用;压力至7-10 atm时,骨水泥呈条状溢出,伸入到周围组织间隙,能起到黏附固定作用。置入骨填充网袋后再灌注骨水泥和直接灌注骨水泥的椎体具有相近的强度和刚度,强于正常椎体。猪腰椎内置入骨填充网袋后再灌注骨水泥6个月后周围骨组织与正常骨组织结构形态及色泽完全相同。表明在椎体压缩骨折手术中应用骨填充网袋可有效恢复椎体高度、强度,防止骨水泥外溢。


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


全文链接:

关键词: 生物材料, 骨生物材料, 椎体压缩性骨折, 力学性能, 老化试验, 强度, 生物相容性

Abstract:

BACKGROUND: Percutaneous vertebroplasty and percutaneous kyphoplasty have become the mainstream clinical methods for the treatment of vertebral compression fractures. However, both of them have several shortcomings such as bone cement leakage, spinal stenosis, nerve compression, pulmonary embolism and other issues.

OBJECTIVE: To verify the possibility of bone filling mesh container prepared by polyethylene terephthalate for the treatment of vertebral compression fractures.
METHODS: The biological properties of bone filling mesh container were examined according to GB/T16886. After sample aging test, the tensile properties of the aged samples and the fresh prepared samples were compared. The expansion and bone cement leakage were evaluated by injecting bone cement into the bone filling mesh container and measuring the pressure. The initial strength and stiffness of the fresh pig vertebrae with calcium phosphate cement injection or with bone filling mesh container filled with calcium phosphate cement were compared. The in vivo bone tissue growth was periodically observed after the lumbar vertebra of 4-month-old pigs was implanted with the bone filling mesh container that was then full of bone cement.
RESULTS AND CONCLUSION: The bone filling mesh container had good biocompatibility. Bone filling mesh containers after 2-year storage had the same tensile strength to the fresh bone filling mesh containers. At ambient conditions, after bone cement injection, bone filling mesh containers could be expanded at 5-10 atm and therefore could play the role of uplift; at 7-10 atm, bone cement could leak out from the bone filling mesh container and enter into the interspace between surrounding bone tissues, thus playing the role of adhesion and fixation. The vertebrae after bone cement injection with or without bone filling mesh containers had the same initial strength and stiffness and exhibited bigger initial strength and stiffness than untreated vertebrae. The in vivo animal experiments proved that bone filling mesh container had no obvious effect on the vertebrae. These findings indicate that the bone filling mesh container can be used to restore the height and strength of the fractured vertebrae. Moreover, it may eliminate bone cement leakage and therefore increase the surgery safety.

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


全文链接:

Key words: biocompatible materials, fractures, compression, biomechanics, polyethylene terephthalates

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