Biomechanical study of vertebroplasty in treatment of thoracolumbar compression fracture
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    Abstract:

    Objective To assess the biomechanical effects and morphologic transformation in treating thoracolumbar traumatic compression fracture by precutaneous vertebralplasty (PVP) combined with reduction.M ethod L1 traumatic compression fracture was created with six fresh calf spines (T12-L3) and the destabilized specimens were augmented using PVP combined with reduction procedure. Each specimen was tested in four states: intact state as the control, L1 flexion-compression fracture state, PVP combined with reduction state, 3000 cycles of fatigue state, respectively. Biomechanical and morphologic analyses were made to test the mechanical stability of the fractured spine.R esults PVP combined with reduction can restore the L1 prevertebral height、strain and the spinal stability to intact states immediately after operation (P>0.05). 3000 fatigue cycles had no effect on the L1 prevertebral height and strain P(>0.05). In physiological loading, the specimens were associated with a significant decrease in rigidity from the intact state with flexio、nleft/right lateral bending (P<0.05) except axial compression and extension(P>0.05)after the fatigue. In left/right axial rotation, PVP was able to stabilize the spine after fatigue but not to the same extent as the intact state. Fatigue had no effect on ROM of T12- T13、L2-L3 at 4Nm moment (P>0.05). In T13-L1, no difference was encountered between the fatigue and intact state in extension、left/right axial rotation (P>0.05), PVP was able to stabilize the spine after fatigue but not to the same extent as the intact state in flexion ,ROM of left/right lateral bending after fatigue was the same as that of fracturedP (>0.05). In L1-L2, no difference was encountered between the fatigue and intact state in extensio、nleft/right axial rotation (P>0.05), PVP was able to stabilize the spine but not to the same extent as the intact state in left/right bending, ROM of flexion after fatigue was the same as that of fractured(P>0.05). No significant difference was found between intact and augmented vertebra for the failure strength after fatigue. Radiographs and cross-sectional observations indicated a good cement-bone bonding and fracture fill. Conclusion PVP combined with reduction can restore the stability of traumatic compression fracture immediately after operation, but the spinal stability decreased in some extent after 3000 cycles fatigue.

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. Biomechanical study of vertebroplasty in treatment of thoracolumbar compression fracture[J]. Journal of medical biomechanics,2008,23(4):311-316

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