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Erscheinungsjahr
- 2016 (2)
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- Englisch (2)
Schlagworte
- Bone marrow extrusion (1)
- Brushite-forming calcium phosphate cement (1)
- CT (1)
- Cement injection (1)
- Computed tomography (1)
- Ex vivo (1)
- High- viscosity PMMA cement (1)
- In vivo (1)
- Large animal model (1)
- Osteoporosis (1)
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.
Injection of poly(methyl methacrylate) cements, one standard Treatment for osteoporotic vertebral body fractures, may lead to critical loads and subsequent fractures in adjacent vertebral bodies. Biodegradable calcium phosphate cements (CPC) with bioinductive growth factors may be an alternative, since they have a Young’s modulus comparable to that of cancellous bone. Non-destructive tests with μCT and quantitative Image evaluation are used to assess new bone growth and material resorption following intravertebral injection of CPC. Immediate deep-freezing of excised bone prevents shrinkage or tissue disintegration and the samples have to be kept frozen for all following steps, including transport, μCT measurements, and subsequent biomechanical tests. Here we will report on a set-up to preserve the frozen state of the material and allow stable long-term serial μCT measurements. In addition, the image processing technique for the evaluation of bone growth and selected results on subsequently carried out compressive strength tests will be presented.