摘要
目的:探索一种高效快速建立体外骨质疏松症(OP)动物模型的方法,并比较不同脊柱内固定方式的生物力学差异,探究OP患者最佳的脊柱内固定方式。方法:OP动物模型的建立选择2.0~2.5岁成年山羊的30个新鲜腰椎为实验材料,随机分为正常组、改良脱钙组和传统脱钙组各10个椎体,正常组椎体在椎弓根和垂直终板钻孔,并用0.9%NaCl溶液浸泡;改良脱钙组椎体在椎弓根和垂直终板钻孔并用脱钙液浸泡;传统脱钙组椎体在椎弓根钻孔,并用脱钙液浸泡。比较3组中每个椎体在脱钙前和脱钙后5、7、9、11、13、15 d的骨密度(BMD)以及脱钙前后的重量。不同脊柱内固定方式的生物力学研究选择2.0~2.5岁成年山羊的30个L3/L4新鲜椎体为实验材料,随机分为正常骨量组和OP组各15个椎体,正常骨量组椎体在椎弓根和垂直终板钻孔,并用0.9%NaCl溶液浸泡;OP组椎体在椎弓根和垂直终板钻孔,并用脱钙液浸泡。再进一步随机分为正常骨量1、2、3组和OP 1、2、3组各5个椎体。正常骨量1组和OP 1组椎体随机选择一侧椎弓根置入骨水泥椎弓根螺钉并行骨水泥强化(推注2.0 mL骨水泥),正常骨量2组和OP 2组椎体随机选择一侧椎弓根置入皮质骨轨迹螺钉,正常骨量3组和OP 3组椎体随机选择一侧椎弓根置入普通椎弓根螺钉。比较各组间的生物力学结果。结果:脱钙前,3组椎体BMD差异无统计学意义(P>0.05),脱钙后,改良脱钙组和传统脱钙组椎体BMD随脱钙时间延长逐渐降低,均低于同时间点的正常组椎体(P均<0.05),改良脱钙组椎体BMD均低于同时间点传统脱钙组椎体(P均<0.05),改良脱钙组和传统脱钙组椎体脱钙后的BMD均低于脱钙前(P均<0.05);改良脱钙组和传统脱钙组椎体脱钙后的重量均低于脱钙前(P均<0.05),并均低于正常组椎体(P均<0.05)。正常骨量1组椎体的最大轴向拔出力、能量吸收值和拔出刚度均高于OP 1组椎体(P均<0.05);正常骨量2组椎体的最大轴向拔出力、能量吸收值和拔出刚度均高于OP 2组椎体(P均<0.05);正常骨量3组椎体的最大轴向拔出力、能量吸收值和拔出刚度均高于OP 3组椎体(P均<0.05);OP 2组椎体的最大轴向拔出力、能量吸收值和拔出刚度均高于OP 1、3组椎体(P均<0.05),且OP组3个亚组的椎体间在最大轴向拔出力、能量吸收值和拔出刚度上的差异均有统计学意义(P均<0.05)。结论:垂直终板钻孔浸泡联合椎弓根注射脱钙液可以快速有效地建立体外OP动物模型,并且在正常骨量和同等OP条件下,皮质骨轨迹螺钉的抗拔出强度最佳。
Objective:To develop an efficient and rapid method for establishing an in vitro osteoporosis animal model,to compare the biomechanical differences among various spinal internal fixation methods,and to identify the optimal fixation method for patients with osteoporosis.Methods:Thirty fresh lumbar vertebrae from adult goats aged 2.0-2.5 years were selected as experimental materials.They were randomly divided into a normal group,a modified decalcification group,and a traditional decalcification group,each containing 10 vertebrae.In the normal group,holes were drilled in the pedicle and vertical endplate,and the vertebrae were soaked in normal saline.In the modified decalcification group,holes were drilled in the pedicle and vertical endplate,and the vertebrae were soaked in decalcifying solution.In the traditional decalcification group,holes were drilled in the pedicle,and the vertebrae were soaked in decalcifying solution.Bone mineral density(BMD)in the three groups was measured before decalcification and on days 5,7,9,11,13,and 15 after decalcification.Vertebral weight was also recorded before and after decalcification.To investigate the biomechanics of different spinal fixation methods,30 L3/L4 fresh vertebrae from adult goats aged 2.0–2.5 years were randomly divided into a normal bone mass group and an osteoporosis group(n=15 each).The vertebrae in the normal bone mass group had holes drilled in the pedicle and vertical endplate,and were soaked in normal saline.The vertebrae in the osteoporosis group had holes drilled in the pedicle and vertical endplate,and were soaked in decalcifying solution.Then they were randomly divided into normal bone mass groups 1,2,and 3,and osteoporosis groups 1,2,and 3,each consisting of 5 vertebrae.One side of the pedicle in the normal bone mass group 1 and osteoporosis group 1 was randomly implanted with a bone cement pedicle screw and reinforced with bone cement(2.0 mL bone cement was injected).One side of the pedicle in the normal bone mass group 2 and the osteoporosis group 2 was randomly implanted with a cortical bone trajectory screw.One side of the pedicle in the normal bone mass group 3 and the osteoporosis group 3 was randomly implanted with a common pedicle screw.The biomechanical results of each group were compared.Results:There was no significant difference in vertebral BMD among the three groups before decalcification(P>0.05).After decalcification,the vertebral BMD in the modified and traditional decalcification groups gradually decreased with prolonged decalcification time,and was lower than that in the normal group at the same time points(all P<0.05).The vertebral BMD in the modified decalcification group was lower than that in the traditional decalcification group at the same time points(all P<0.05).The vertebral BMD in the modified and traditional decalcification groups after decalcification was lower than that before decalcification(all P<0.05).The vertebral weight after decalcification was significantly lower in the modified and traditional decalcification groups than that before decalcification(all P<0.05),and was lower than that in the normal group(all P<0.05).The maximum axial pull-out force,energy absorption,and pull-out stiffness of the vertebrae in normal bone mass group 1 were higher than those in osteoporosis group 1(all P<0.05);in normal bone mass group 2 were higher than those in osteoporosis group 2(all P<0.05);in normal bone mass group 3 were higher than those in osteoporosis group 3(all P<0.05).Among the osteoporosis groups,group 2 had higher values of maximum axial pull-out force,energy absorption,and pull-out stiffness than groups 1 and 3(all P<0.05).There were significant differences in maximum axial pull-out force,energy absorption,and pull-out stiffness among the three subgroups of the osteoporosis group(all P<0.05).Conclusions:Vertical endplate drilling and immersion combined with pedicle injection of decalcifying solution can establish an osteoporosis animal model in vitro more quickly and effectively.Furthermore,under the conditions of normal bone mass and the same osteoporosis,the pull-out strength of cortical bone trajectory screws is the best.
作者
王艳
范华华
申雄成
WANG Yan;FAN Huahua;SHEN Xiongcheng(Department of Spinal Surgery,Zunyi First People's Hospital,Zunyi 563000,Guizhou,China)
出处
《中华骨与关节外科杂志》
北大核心
2025年第8期737-745,共9页
Chinese Journal of Bone and Joint Surgery
基金
合肥市科技计划项目[遵市科合HZ字(2022)64号]
贵州省卫生健康委科学技术基金(gzwkj2024-410)。
关键词
脱钙
骨质疏松症
椎体模型
内固定
生物力学
Decalcification
Osteoporosis
Vertebral Model
Internal Fixation
Biomechanics
