TY - JOUR A1 - Xin, L. A1 - Bungartz, M. A1 - Maenz, S. A1 - Horbert, V. A1 - Hennig, M. A1 - Illerhaus, Bernhard A1 - Günster, Jens A1 - Bossert, J. A1 - Bischoff, S. A1 - Borowski, J. A1 - Schubert, H. A1 - Jandt, K. A1 - Kunisch, E. A1 - Kinne, R. A1 - Brinkmann, O. T1 - Decreased extrusion of calcium phosphate cement versus high viscosity PMMA cement into spongious bone marrow—an ex vivo and in vivo study in sheep vertebrae N2 - Vertebroplasty or kyphoplasty of osteoporotic vertebral fractures bears the risk of pulmonary cement embolism (3.5%–23%) caused by leakage of commonly applied acrylic polymethylmethacrylate (PMMA) cement to spongious bone marrow or outside of the vertebrae. Ultraviscous cement and specific augmentation systems have been developed to reduce such adverse effects. Rapidly setting, resorbable, physiological calcium phosphate cement (CPC) may also represent a suitable alternative. PURPOSE: This study aimed to compare the intravertebral extrusion of CPC and PMMA cement in an ex vivo and in vivo study in sheep. STUDY DESIGN/SETTING: A prospective experimental animal study was carried out. METHODS: Defects (diameter 5 mm; 15 mm depth) were created by a ventrolateral percutane-ous approach in lumbar vertebrae of female Merino sheep (2–4 years) either ex vivo (n = 17) or in vivo (n = 6), and injected with: (1) CPC (L3); (2) CPC reinforced with 10% poly(l-lactide-co-glycolide) (PLGA) fibers (L4); or (3) PMMA cement (L5; Kyphon HV-R). Controls were untouched (L1) or empty defects (L2). The effects of the cement injections were assessed in vivo by blood gas analysis and ex vivo by computed tomography (CT), micro-CT (voxel size: 67 µm), histology, and biomechanical testing. KW - Bone marrow extrusion KW - Brushite-forming calcium phosphate cement KW - Cement injection KW - Ex vivo KW - High- viscosity PMMA cement KW - In vivo KW - Large animal model KW - Sheep KW - Vertebroplasty PY - 2016 U6 - https://doi.org/10.1016/j.spinee.2016.07.529 SN - 1529-9430 SN - 1878-1632 VL - 16 IS - 12 SP - 1468 EP - 1477 PB - Elsevier Inc. AN - OPUS4-38058 LA - eng AD - Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin, Germany ER - TY - JOUR A1 - Kinne, R. W. A1 - Gunnella, F. A1 - Kunisch, E. A1 - Heinemann, S. A1 - Nies, B. A1 - Maenz, S. A1 - Horbert, V. A1 - Illerhaus, Bernhard A1 - Huber, R. A1 - Firkowska-Boden, I. A1 - Bossert, J. A1 - Jandt, K. D. A1 - Sachse, A. A1 - Bungartz, M. A1 - Brinkmann, O. T1 - Performance of calcium phosphate cements in the augmentation of sheep vertebrae - An ex vivo study N2 - Oil-based calcium phosphate cement (Paste-CPC) shows not only prolonged shelf life and injection times, but also improved cohesion and reproducibility during application, while retaining the advantages of fast setting, mechanical strength, and biocompatibility. In addition, poly(L-lactideco-glycolide) (PLGA) fiber reinforcement may decrease the risk for local extrusion. Bone defects (diameter 5 mm; depth 15 mm) generated ex vivo in lumbar (L) spines of female Merino sheep (2–4 years) were augmented using: (i) water-based CPC with 10% PLGA fiber reinforcement (L3); (ii) Paste-CPC (L4); or (iii) clinically established polymethylmethacrylate (PMMA) bone cement (L5). Untouched (L1) and empty vertebrae (L2) served as controls. Cement performance was analyzed using micro-computed tomography, histology, and biomechanical testing. Extrusion was comparable for Paste-CPC(-PLGA) and PMMA, but significantly lower for CPC + PLGA. Compressive strength and Young’s modulus were similar for Paste-CPC and PMMA, but significantly higher compared to those for empty defects and/or CPC + PLGA. Expectedly, all experimental groups showed significantly or numerically lower compressive strength and Young’s modulus than those of untouched controls. Ready-to-use Paste-CPC demonstrates a performance similar to that of PMMA, but improved biomechanics compared to those of water-based CPC + PLGA, expanding the therapeutic arsenal for bone defects. O, significantly lower extrusion of CPC + PLGA fibers into adjacent lumbar spongiosa may help to reduce the risk of local extrusion in spinal surgery. KW - Sheep KW - PMMA KW - Calcium phosphate bone cement KW - Oil-based KW - Ready-to-use KW - Water-based KW - Micro-CT KW - Compressive strength KW - Young’s modulus PY - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:b43-569072 SN - 1996-1944 VL - 14 IS - 14 SP - 1 EP - 12 PB - MDPI CY - Basel AN - OPUS4-56907 LA - eng AD - Bundesanstalt fuer Materialforschung und -pruefung (BAM), Berlin, Germany ER -