Application and modification of bone cement in vertebroplasty: A literature review

Abstract

Vertebral compression fractures are more common in the elderly, particularly in postmenopausal women. Most of these people are accompanied by osteoporosis, which can easily lead to spinal deformities and fractures. Once a fracture occurs, the patient would have severe pain response, limited spinal movement, and need to stay in bed for a long time, resulting in a significant decrease in their quality of life. Percutaneous vertebroplasty (PVP) is a minimally invasive spinal surgery that injects bone cement into the diseased vertebrae for therapeutic purposes. It can quickly relieve pain and stabilize the spine. It is widely used in the treatment of vertebral compression fractures and is currently an ideal treatment method. There are many materials of bone cement used in clinical treatment, and each material has unique characteristics. Many scholars would modify the bone cement according to the advantages and disadvantages to make it more suitable for clinical use. In this review, we discuss the clinical application and modification of bone cement.

Antioxidant flavonoid-loaded nano-bioactive glass bone paste: in vitro apatite formation and flow behavior

“…12 Injectability is signicant for minimally invasive surgery in lling bone defects and cracks through percutaneous vertebroplasty. 5,13,14 Injectable bioactive materials are good candidates for lling bone defects and stabilizing osteoporotic bone. 14 In addition, injectable bone lling materials are suitable options for treating dental root canal and other defects, which have small holes and restricted accessibility.…”

“…5,13,14 Injectable bioactive materials are good candidates for lling bone defects and stabilizing osteoporotic bone. 14 In addition, injectable bone lling materials are suitable options for treating dental root canal and other defects, which have small holes and restricted accessibility. 15 Previously, bioactive pastes made of a bioactive solid phase and aqueous solutions of biocompatible natural polymers that do not undergo a cement setting reaction were developed.…”

Tough, Injectable Calcium Phosphate Cement Based Composite Hydrogels to Promote Osteogenesis

“…Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are widely used in the treatment of osteoporotic vertebral compression fractures (OVCFs). PVP and PKP refer to a minimally invasive spine surgery technique that injects bone cement into the vertebral body through the pedicle or beside the pedicle to relieve back pain, increase the stability of the vertebral body, and restore the height of the vertebral body [ 12 ]. Pedicle screw fixation is widely used to treat spinal disease, and the number of spine surgeries in elderly patients with osteoporosis continues to increase worldwide due to the increasingly aged population [ 13 , 14 ].…”

“…The common types of bone cement used clinically include polymethylmethacrylate (PMMA), calcium phosphate cement (CPC), calcium sulfate cement (CSC), and composite bone cement. Currently, PMMA bone cement is the most commonly used bone cement in PVP/PKP and CAPS, having advantages such as biocompatibility, injectability, and good mechanical properties [ 12 , 15 ]. However, PMMA also has various disadvantages, such as it cannot be degraded, a lack of biocompatibility, a propensity to cause surrounding tissue damage due to polymerization exotherm, and residual monomer toxicity [ 12 ].…”

“…Currently, PMMA bone cement is the most commonly used bone cement in PVP/PKP and CAPS, having advantages such as biocompatibility, injectability, and good mechanical properties [ 12 , 15 ]. However, PMMA also has various disadvantages, such as it cannot be degraded, a lack of biocompatibility, a propensity to cause surrounding tissue damage due to polymerization exotherm, and residual monomer toxicity [ 12 ]. In addition, the injection of PMMA bone cement into a vertebral body increases the possibility of fracture of the adjacent vertebral body.…”