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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

  • 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);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.zeige mehrzeige weniger

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Metadaten
Autoren/innen:L. Xin, M. Bungartz, S. Maenz, V. Horbert, M. Hennig, Bernhard Illerhaus, Jens Günster, J. Bossert, S. Bischoff, J. Borowski, H. Schubert, K. Jandt, E. Kunisch, R. Kinne, O. Brinkmann
Dokumenttyp:Zeitschriftenartikel
Veröffentlichungsform:Verlagsliteratur
Sprache:Englisch
Titel des übergeordneten Werkes (Englisch):The Spine Journal
Jahr der Erstveröffentlichung:2016
Organisationseinheit der BAM:5 Werkstofftechnik
5 Werkstofftechnik / 5.4 Keramische Prozesstechnik und Biowerkstoffe
Verlag:Elsevier Inc.
Jahrgang/Band:16
Ausgabe/Heft:12
Erste Seite:1468
Letzte Seite:1477
DDC-Klassifikation:Technik, Medizin, angewandte Wissenschaften / Ingenieurwissenschaften / Ingenieurwissenschaften und zugeordnete Tätigkeiten
Freie Schlagwörter:Bone marrow extrusion; Brushite-forming calcium phosphate cement; Cement injection; Ex vivo; High- viscosity PMMA cement; In vivo; Large animal model; Sheep; Vertebroplasty
Themenfelder/Aktivitätsfelder der BAM:Material
DOI:https://doi.org/10.1016/j.spinee.2016.07.529
URL:http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=Alerting&SrcApp=Alerting&DestApp=WOS&DestLinkType=FullRecord;UT=WOS:000394875800008
ISSN:1529-9430
ISSN:1878-1632
Verfügbarkeit des Dokuments:Datei im Netzwerk der BAM verfügbar ("Closed Access")
Datum der Freischaltung:03.01.2017
Referierte Publikation:Ja
Datum der Eintragung als referierte Publikation:07.04.2017