不同降温法延长椎体成形术中骨水泥注射时间的骨水泥材料性能研究

doi:10.3877/cma.j.issn.2095-5782.2024.03.007

目的

探索经不同降温处理的骨水泥其聚合时间、温度和力学性能变化。

方法

骨水泥按不同降温法分成三个大组，A组为对照组；B组为4℃预降温组，将骨水泥置于4℃中24 h再混合粉液；C组为0℃快速降温组，将骨水泥粉液混合后置于0℃快速降温。每一大组再分成2个小组，第一小组待骨水泥进入黏稠期后将其置于22℃继续实验（A1，B1，C1组），第二小组则待骨水泥进入黏稠期后，再置于37℃（A2，B2，C2组）继续实验。分别测量骨水泥的聚合时间（稀薄期、黏稠期、硬化期的维持时间）、聚合温度及力学性能（强度和刚度）,采用单因素方差分析比较A1、B1、C1组间以及A2、B2、C2组间的材料性能差异。采用配对t检验比较同一大组的两小组（A1-A2，B1-B2，C1-C2）间材料性能差异，P < 0.05为差异有统计学意义。

结果

C1组黏稠期时间（1 880.0 ± 59.9）s较A1和B1组延长，差异有统计学意义（P < 0.05）；C2组黏稠期时间（193.8 ± 14.7）s较C1组缩短，且与A2和B2组差异有统计学意义。C1组聚合最高温度（11.6 ± 0.7）℃较A1和B1组降低，差异有统计学意义（P < 0.05），C2组聚合最高温度（95.7 ± 2.2）℃较C1组升高，且与A2和B2组差异无统计学意义（P > 0.05）。C1组骨水泥的强度（81.3 ± 3.6）MPa低于A1和B1组，差异有统计学意义（P < 0.05），C2组强度（90.9 ± 3.5）MPa较C1组提升，且与A2和B2组的差异无统计学意义（P > 0.05）。A1、B1、C1组间，以及A2、B2、C2组间的骨水泥刚度差异无统计学意义（P > 0.05）。

结论

0℃快速降温以延长骨水泥可注射工作时间的方法，是一种安全、可行、有效的方法。

关键词: 骨水泥, 低温, 聚合时间, 力学性能, 经皮椎体成形术

Objective

To explore the changes of polymerization time, polymerization temperature and mechanical properties of bone cement treated with different cooling treatments.

Methods

Methyl acrylate bone cement was divided into three groups according to different cooling methods. Group A was the control group. Group B was a 4℃ pre-cooling group, in which the bone cement was placed in a 4℃ temperature for 24 hours before powder and liquid mixing. Group C was the 0℃ rapid cooling group, and the powder and liquid of the bone cement were mixed and then placed in the 0℃ for rapid cooling. Each group was further divided into two subgroups. The first subgroup waited for the cement to enter the viscous phase and then placed it at 22℃ to continue the experiment (group A1, B1, and C1), and the second subgroup waited for the cement to enter the viscous phase and then placed it at 37℃ to continue the experiment (group A2, B2, and C2). The three indexes of bone cement, which include the polymerization time (the maintenance time of rarefaction phase, viscous phase, and hardening phase), the polymerization temperature, and the mechanical properties (strength and stiffness), were measured. The material properties among subgroups A1, B1, and C1; and among subgroups A2, B2, and C2 were compared by one-way ANOVA. The paired t test was used to compare the differences of material properties between the two subgroups (A1-A2, B1-B2, C1-C2) of the same group, and P < 0.05 was considered statistically significant.

Results

The duration of the viscous phase (1 880.0 ± 59.9 seconds) of group C1 was significantly longer than that of group A1 and B1 (P < 0.05). The duration of viscous phase (193.8 ± 14.7 seconds) of the group C2 was significantly shorter than that of group C1, furthermore, there was no significant difference among groups C2, A2 and B2. The maximum polymerization temperature of the bone cement in group C1 (11.6 ± 0.7)℃ was significantly lower than that in group A1 and B1 (P < 0.05), however, the maximum polymerization temperature of the group C2 (95.7 ± 2.2)℃ was significantly higher than that of group C1, furthermore, there was no significant difference among groups C2, A2 and B2. The strength of the bone cement in group C1 (81.3 ± 3.6) Mpa was significantly lower than that in group A1 and B1 (P < 0.05), however, the strength of the bone cement in group C2 (90.9 ± 3.5) Mpa, was significantly higher than that in group C1, furthermore, there was no significant difference among groups C2, A2 and B2. There was no significant difference in cement stiffness among groups A1, B1, and C1, and among groups A2, B2, and C2.

Conclusion

Rapid cooling at 0℃ to prolong the working time of bone cement injection is a safe, feasible and effective method.

Key words: Bone cement, Hypothermia, Polymerization time, Mechanical properties, Percutaneous vertebroplasty

表1 不同温度降温处理骨水泥，再置于22℃下继续聚合的骨水泥材料性能表

组别	稀薄期持续时间（s）	黏稠期持续时间（s）	硬化期持续时间（s）	最高温度（℃）	50℃以上时间（s）	强度（MPa）	刚度（N/m）
A1	179.5 ± 9.0	227.3 ± 28.0	217.5 ± 14.8	93.5 ± 1.7	551.0 ± 69.9	91.3 ± 3.6	1 477.9 ± 137.4
B1	444.7 ± 21.8	306.5 ± 40.0	137.2 ± 46.5	100.6 ± 3.8	575.2 ± 41.3	90.7 ± 3.4	1 460.1 ± 144.3
C1	3 273.3 ± 125.4	1 880.0 ± 59.9	1 411.7 ± 90.2	11.6 ± 0.7	/	81.3 ± 3.6	1 412.5 ± 134.9
F值	3 252.846	2 614.684	872.224	2 507.706	0.532	14.812	0.356
P值	0.000^a	0.000^a	0.000^a	0.000^a	0.482	0.000^a	0.707

表1 不同温度降温处理骨水泥，再置于22℃下继续聚合的骨水泥材料性能表

组别	稀薄期持续时间（s）	黏稠期持续时间（s）	硬化期持续时间（s）	最高温度（℃）	50℃以上时间（s）	强度（MPa）	刚度（N/m）
A1	179.5 ± 9.0	227.3 ± 28.0	217.5 ± 14.8	93.5 ± 1.7	551.0 ± 69.9	91.3 ± 3.6	1 477.9 ± 137.4
B1	444.7 ± 21.8	306.5 ± 40.0	137.2 ± 46.5	100.6 ± 3.8	575.2 ± 41.3	90.7 ± 3.4	1 460.1 ± 144.3
C1	3 273.3 ± 125.4	1 880.0 ± 59.9	1 411.7 ± 90.2	11.6 ± 0.7	/	81.3 ± 3.6	1 412.5 ± 134.9
F值	3 252.846	2 614.684	872.224	2 507.706	0.532	14.812	0.356
P值	0.000^a	0.000^a	0.000^a	0.000^a	0.482	0.000^a	0.707

表2 不同温度降温处理骨水泥，再置于37℃下继续聚合的骨水泥材料性能

组别	稀薄期持续时间（s）	黏稠期持续时间（s）	硬化期持续时间（s）	最高温度（℃）	50℃以上时间（s）	强度（MPa）	刚度（N/m）
A2	179.5 ± 9.0	160.7 ± 10.9	98.2 ± 5.8	96.2 ± 5.2	334.6 ± 56.0	91.5 ± 3.5	1 514.8 ± 141.5
B2	444.7 ± 21.8	178.5 ± 15.0	90.7 ± 5.7	97.6 ± 7.4	356.3 ± 36.1	91.3 ± 3.9	1 482.1 ± 126.6
C2	3 273.3 ± 125.4	193.8 ± 14.7	95.0 ± 3.5	95.7 ± 2.2	326.3 ± 10.7	90.9 ± 3.5	1 482.5 ± 132.5
F值	3 252.846	8.883	3.237	0.199	0.947	0.051	0.118
P值	0.000^a	0.003^a	0.068	0.821	0.410	0.950	0.890

表2 不同温度降温处理骨水泥，再置于37℃下继续聚合的骨水泥材料性能

组别	稀薄期持续时间（s）	黏稠期持续时间（s）	硬化期持续时间（s）	最高温度（℃）	50℃以上时间（s）	强度（MPa）	刚度（N/m）
A2	179.5 ± 9.0	160.7 ± 10.9	98.2 ± 5.8	96.2 ± 5.2	334.6 ± 56.0	91.5 ± 3.5	1 514.8 ± 141.5
B2	444.7 ± 21.8	178.5 ± 15.0	90.7 ± 5.7	97.6 ± 7.4	356.3 ± 36.1	91.3 ± 3.9	1 482.1 ± 126.6
C2	3 273.3 ± 125.4	193.8 ± 14.7	95.0 ± 3.5	95.7 ± 2.2	326.3 ± 10.7	90.9 ± 3.5	1 482.5 ± 132.5
F值	3 252.846	8.883	3.237	0.199	0.947	0.051	0.118
P值	0.000^a	0.003^a	0.068	0.821	0.410	0.950	0.890

表3 22℃和37℃下完成聚合的骨水泥材料性能配对t检验结果

组别		黏稠期时间（s）	硬化期时间（s）	最高温度（℃）	50℃以上时间（s）	强度（MPa）	刚度（N/m）
A1-A2	t值	6.472	19.932	-1.607	18.105	-0.278	-0.868
	P值	0.001^a	0.000^a	0.169	0.000^a	0.792	0.425
B1-B2	t值	4.796	2.603	0.846	7.595	-1.892	-0.810
	P值	0.005^a	0.048^a	0.436	0.001^a	0.117	0.455
C1-C2	t值	65.258	34.947	-78.085	/	-19.350	-2.924
	P值	0.000^a	0.000^a	0.000^a	/	0.000^a	0.033^a

表3 22℃和37℃下完成聚合的骨水泥材料性能配对t检验结果

组别		黏稠期时间（s）	硬化期时间（s）	最高温度（℃）	50℃以上时间（s）	强度（MPa）	刚度（N/m）
A1-A2	t值	6.472	19.932	-1.607	18.105	-0.278	-0.868
	P值	0.001^a	0.000^a	0.169	0.000^a	0.792	0.425
B1-B2	t值	4.796	2.603	0.846	7.595	-1.892	-0.810
	P值	0.005^a	0.048^a	0.436	0.001^a	0.117	0.455
C1-C2	t值	65.258	34.947	-78.085	/	-19.350	-2.924
	P值	0.000^a	0.000^a	0.000^a	/	0.000^a	0.033^a

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Experimental study on the materials properties of bone cement treated by different cooling methods to prolong it's injection time in the vertebroplasty

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Experimental study on the materials properties of bone cement treated by different cooling methods to prolong it's injection time in the vertebroplasty