| 陈珑,倪才方,刘一之,杨惠林,唐天驷,金泳海,邹建伟,丁乙,王以进.硫酸钡为助显剂行经皮椎体成形术实验与初步临床应用[J].中国医学影像技术,2005,21(7):1085~1088 |
| 硫酸钡为助显剂行经皮椎体成形术实验与初步临床应用 |
| Experimental and clinical study on barium used to increase radiopacity of bone cement for vertebroplasty |
| 投稿时间：2005-03-06 修订日期：2005-05-17 |
| DOI： |
| 中文关键词: 聚甲基丙烯酸类 放射学,介入性 材料实验 生物力学实验 脊柱疾病 |
| 英文关键词:Polymethacrylic acids Radiology, interventional Materials testing Biomechanical testing Spinal diseases |
| 基金项目:江苏省"135"工程重点人才基金(RC2003097)。 |
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| 中文摘要: |
| 目的 探索利用硫酸钡为助显剂行经皮椎体成形术术中所用骨水泥的合适配置比例。方法 将骨水泥按粉液比(g/ml)为3∶2,粉剂中BaSO4的百分比含量为0、10%、20%、30%,分成4个组,每组8个样本,测定其CT值、强度、刚度。收集2例老年女性的腰椎共10个椎体,将其制成椎体压缩性骨折模型,并测定椎体的刚度及强度。然后利用粉液比(g/ml)为3∶2,粉剂中BaSO4的百分比含量为20%的骨水泥对其行椎体成形术,术后再次测量其刚度和强度。利用上述配置比例的骨水泥对31例患者的36个病变椎体行经皮椎体成形术治疗。记录患者术前、术后24h、术后1周、1个月的疼痛视觉模拟划线法(VAS)得分及并发症情况。结果 粉剂中BaSO4的百分比含量增加,骨水泥的CT值随之增加,刚度和强度随之降低(P＜0.05)。粉液比(g/ml)为3∶2,粉剂中BaSO4的百分比含量为20%的骨水泥能有效恢复骨折椎体的刚度及强度,手术前后椎体生物力学性能有差别(P＜0.05);将此种配置比例的骨水泥用于临床椎体成形术,患者手术前后的疼痛得分(VAS)改善(P＜0.05),除8例发生无症状的骨水泥渗漏外,无严重并发症发生。结论 粉液比(g/ml)为3∶2,粉剂中BaSO4的百分比含量为20%的骨水泥具有满意的X线显影能力,能够有效增强病变椎体的生物力学性能,临床使用疗效稳定。 |
| 英文摘要: |
| Objective To investigate preferable mixing ratio of barium used to increase radiopacity of bone cement for vertebroplasty. Methods Bone cement was classified into four groups according to the ratio of powder/liquid (g/ml) as 3∶2, and the percentage of BaSO4 in powder as 0, 10%, 20%, 30%, respectively. CT value, strength and stiffness of bone cement were measured respectively in each group. Five vertebral bodies (VBs) from each of two spines harvested from female cadavers were disarticulated and compressed in a materials testing machine to determine initial strength and stiffness.The fractures were repaired by using bone cement whose ratio of powder/iquid (g/ml)was 3∶2 and the percentage of BaSO4 in powder was 20%. After augmentation,the VBs were recrushed. Thirty-one cases with 36 vertebraes underwent PVP, which were performed with bone cement whose ratio of powder/iquid (g/ml) was 3∶2 and the percentage of BaSO4 in powder was 20%. Visual analogue scale point (VAS) (10-point scale) before vertebroplasty,24 hours after, one week and one month after vertebroplasty were recorded respectively. Results The CT value, the strength and the stiffness of bone cement with different percentage of BaSO4 in powder were significantly different(P＜0.05). VBs augmented with bone cement whose ratio of powder/iquid (g/ml) was 3∶2 and the percentage of BaSO4 in powder was 20% have a different biomechanical properties compared with preaugmentated. There are significant differences among the scores of VAS with different time points. No further or new vertebral compression occurred in all patients during the follow-up of 193-611 days. No major compications occurred in this series, except asymptoamic cement leak around vertebrae. Conclusion Bone cement whose ratio of powder/iquid (g/ml) 3∶2 and the percentage of 20% BaSO4 in powder has satisfactory radiopacity. It can increase the biomechanical properties of VBs effectively. Stable therapeutic effects can be attained by using this kind of bone cement on percutaneous vertebroplasty. It's feasible to apply this kind of bone cement on the percutaneous vertebroplasty. |
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