Application of New Bone Cement Biomaterials in Osteoporotic Compression Fractures

Abstract

Silk fibroin (SF) is a kind of natural protein, which is widely used in biomedical materials because of its biodegradability, easy modification, biocompatibility and good mechanical properties. In this exploration, it was used as bone cement materials and compared with conventional bone cement materials to obtain the efficacy of different bone cement materials in the treatment of osteoporotic vertebral compression fractures. First, the effect of degumming time of silk in boiling on SF was analyzed. Then, hydroxyapatite silk fibroin (HA-SF) was added to calcium phosphate cement (Cap) by coprecipitation method. The properties of the composite bone cement were analyzed by morphology analysis and mechanical properties testing. Finally, 40 patients who underwent percutaneous kyphoplasty (PKP) from May 2019 to June 2020 were selected and divided into two groups. Among them, one group used the composite bone cement material proposed in this exploration, and the other group used the conventional bone cement material. Patients in different groups were evaluated for postoperative treatment. In the experiment, the sericin could be removed by boiling, and the SF short fiber could be peeled by boiling for a long time; the compressive strength of Cap material could be improved by adding HA-SF. At the same time, the introduction of SF could shorten the coagulation time under the premise of injectability, so as to improve the anti-collapse ability of Cap; the patients using different bone cement materials were compared, and the cobb angle, anterior height of vertebral body and VAS score of different groups were analyzed 3 days and 3 months after operation. The results show that the bone cement material proposed in this exploration can effectively treat osteoporotic vertebral compression fractures.

Comparative analysis of risk factors associated with degeneration of adjacent segments: zero-profile anchored spacer vs. anterior cervical plate and cage construct

“…(3) cervical abnormalities; (4) severe unstable cervical spine with vertical displacement >2 mm or with angular displacement >2°; (5) posterior longitudinal ligament ossification; (6) cervical tumour or infection; and (7) a history of cervical spine surgery.…”

“…Anterior cervical decompression and fusion (ACDF) is an option commonly applied to cervical spondylosis caused by disc herniation or ossification of the posterior longitudinal ligament, which provides adequate access to the compression of the spinal cord, improves localised kyphotic deformity, and re-establishes sagittal alignment of the cervical spine (2). However, long-term arthrodesis of the spinal segments may lead to excessive biological stress at the unfused levels, and there is evidence that a proportion of 25-89% of patients will again have clinical symptoms in the adjacent segment that might require secondary surgery (3)(4)(5). The main manifestation of adjacent segment degeneration (ASD) is the reduction in height of the intervertebral space that may allow for narrowing of the intervertebral foramen, ossification of the posterior longitudinal ligament, reduced mobility of the fused segment, and reappearance of cervical spondylosis symptoms.…”