Measurement and Analysis of Vertebral Pressure in Percutaneous Vertebroplasty
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    Abstract:

    Objective To analyze the possible causes of complication in vertebroplasty (PVP) operation from the view of biomechanics and provide some preventive suggestions accordingly. Method The 16 lunbar spinal vertebrae with osteoprotic compression fracture from the 14 elderly corpses (the vertebral bone mineral density T<-2.5) were selected and monitored to meet the demands of clinical assessment of PVP under C-arm. With the adoption of micro pressure unisensor (5mv/bar) and carrier frequency amplifier as well as its Signai-Soft6000 (PICAS & SIGNALOG 6000) produced by AG company and Peekel Instrument GmbH respectively, the dynamic changes with pressure in each vertebrae vertebroplasty were assessed by using statistical description and analysis through descriptive statistics and nonparametric statistical approach; the possibility of complication was also clinically examined. Result Each vertebra of vertebroplasty met the clinical evaluation requirements. Each time after putting to (the instrument with the set of Yamshidi-Nadel provided by Kypho of America for injection of bone cement into the vertebrae; each putting could contain about 1.5 mL bone cement) inject bone cement into the vertebrae, the pressure P(subscript max) was not very high, with 500 kPa bar below for majority and the effect caused showed a significant statistical difference (P<0.01). Whereas, the pressure within the area of the vertebral P(subscript area) value was not high either, the majority was 10.00 Unit lower, which also led to the effects of significant difference (P<0.01). Both two states showed partial distribution. After making the statistical analysis to the casual two puttings between the first, second, third and fourth putting of each vertebrae, there existed the general differences. The differences were also found between other puttings (a<0.0083) on the statistics basis apart from between the first and second and between the third and fourth. Conclusions For osteoporosis of lumbar vertebral compression fractures vertebroplasty (PVP), its bone cement injected into the vertebrae could achieve clinical evaluation requirements with three putts enough (about 4.5 ml of bone cement), and no need to have fourth-bone cement injection, which not only could avoid frivolous behavior, but also reduce the risk of surgical complications.

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HU Xiao-hui, Fritz-Uwe Niethard, ZHANG Yang, WU Chun-gen, ZHANG Ming. Measurement and Analysis of Vertebral Pressure in Percutaneous Vertebroplasty[J]. Journal of medical biomechanics,2009,24(1):44-49

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History
  • Received:August 26,2008
  • Revised:November 03,2008
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