In vitro mechanical study of different approaches in percutaneous kyphoplasty
10.3760/cma.j.cn115530-20230908-00098
- VernacularTitle:不同入路经皮椎体后凸成形术的体外力学研究
- Author:
Rui ZHONG
1
;
Runsheng WANG
;
Jing DAN
;
Jingquan LI
;
Bin HU
;
Chuanen WANG
;
Daode LIU
Author Information
1. 成都体育学院附属体育医院脊柱病科，成都 610041
- Keywords:
Osteoporosis;
Spinal fractures;
Fractures, compression;
Kyphoplasty;
Biomechanics
- From:
Chinese Journal of Orthopaedic Trauma
2023;25(10):890-896
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the restoration effects and mechanical reconstruction between different approaches in percutaneous kyphoplasty (PKP) through an in vitro mechanical experiment. Methods:T 7 to L 4 segments of adult male embalmed spinal specimens were selected for this experiment. Single vertebral specimens were randomly divided into 4 groups: unilateral angled approach group (Group A), unilateral transpedicular approach group (Group B), unilateral oblique approach group (Group C), and bilateral transpedicular approach group (Group D) ( n=10). The anterior and posterior edges of the vertebral body were measured, and the vertebral volumes were calculated and compared. After the model of osteoporotic vertebral compression fracture (OVCF) was established on a biomechanical machine, the anterior and posterior edges of the vertebral body were measured again. After the 4 groups of specimens were subjected to PKP via different approaches, Micro-CT examination of the vertebral bodies was conducted to measure the postoperative anterior and posterior edges of the vertebral body. The original strength and stiffness of the vertebral body, the stiffness after modeling, the postoperative strength, the postoperative stiffness on the puncture and contralateral sides, and postoperative overall stiffness were recorded. The distribution of bone cement in the vertebral body, recovery of anterior and posterior heights, strength, and stiffness were compared among the 4 groups. Results:There was no statistically significant difference in the vertebral volume among the 4 groups ( P>0.05). The amount of bone cement in group D was significantly larger than that in the other 3 groups ( P<0.05). There was no statistically significant difference among the 4 groups in terms of vertebral height recovery, original strength, original stiffness, stiffness after modeling, or postoperative overall stiffness ( P>0.05). There was no statistically significant difference between the postoperative strength and the original strength in the 4 groups ( P>0.05). The postoperative stiffness on the puncture side in the 4 groups and the postoperative stiffness on the contralateral side in groups A and D were significantly higher than those after modeling ( P<0.05), but there was no statistically significant difference in the contralateral stiffness in groups B and C between postoperation and post-modeling ( P>0.05). Conclusions:In PKP, the unilateral angled approach, unilateral transpedicular approach, unilateral oblique approach, and bilateral transpedicular approach all can effectively restore the height, strength and overall stiffness of the responsible vertebral body. The unilateral angled approach and the bilateral transpedicular approach can achieve balanced restoration of the stiffness on bilateral sides of the responsible vertebral body.
