Wissenschaftliche Artikel der BAM
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Performance of calcium phosphate cements in the augmentation of sheep vertebrae - An ex vivo study
(2021)
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.
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.