Biomechanical Evaluation of a New Bone Cement for Use in Vertebroplasty

Belkoff, Stephen M.; Mathis, John M.; Erbe, Erik M.; Fenton, David C.

doi:10.1097/00007632-200005010-00004

Cited by 208 publications

(115 citation statements)

References 20 publications

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“…Properties of bone conductivity and absence of exotherm of hydroxyapatite-forming materials make them an attractive option to PMMA cements [4]. Thus, we believe use of HA improved cement is worth it because of its reduced possibility of causing intra-cardiac and distant embolism when compared to use of PMMA cement alone.…”

Section: Calcium Phosphate and Hydroxyapatitementioning

confidence: 99%

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A Review of PMMA Bone Cement and Intra-Cardiac Embolism

Shridhar¹,

Chen²,

Khalil³

et al. 2016

Preprint

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Percutaneous vertebroplasty procedure is of major importance, given the significant increasing aging population and higher number of orthopedic procedures related to vertebral compression fractures. Vertebroplasty is a complex technique involving injection of polymethylmethacrylate (PMMA) into the compressed vertebral body for mechanical stabilization of the fracture. Our understanding and ability to modify these mechanisms through alterations in cement material is rapidly evolving. However, the rate of cardiac complications secondary to PMMA injection and subsequent cement leakage has increased with time. The following review considers the main features of PMMA bone cement on the heart, and the extent of influence of materials on cardiac embolism. Clinically, cement leakage results in life-threatening cardiac injury. The convolution of this outcome through an appropriate balance of complex material properties is highlighted via clinical case report.

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Section: Calcium Phosphate and Hydroxyapatitementioning

confidence: 99%

“…Orthocomp ™ is composite material with a matrix of Bis-phenol glycidyl dimethacrylate (BisGMA), Bis-phenol ethoxy dimethacrylate (BisEMA), and triethyleneglycol dimethacrylate (TEGDMA) [4]. It is biocompatible, has lower setting exotherm and good material properties.…”

Section: Orthocomp ™ and Hydroxyapatitementioning

confidence: 99%

A Review of PMMA Bone Cement and Intra-Cardiac Embolism

Shridhar¹,

Chen²,

Khalil³

et al. 2016

Preprint

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“…It is a relatively easy procedure but can only indirectly reduce a fractured vertebral body, and the means of augmenting the anterior column are limited. Hardware failure and a loss of reduction are recognized complications caused by insufficient anterior column support [5][6][7]. Anterior procedures using iliac grafts or cages have been proposed to address the problem of this anterior column insufficiency, sometimes also in combination with posterior instrumentation.…”

Section: Introductionmentioning

confidence: 99%

Short segment pedicle screw instrumentation and augmentation vertebroplasty in lumbar burst fractures: an experience

Afzal¹,

Saleem²,

Dhar³

2008

Eur Spine J

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To assess the efficacy and feasibility of vertebroplasty and posterior short-segment pedicle screw fixation for the treatment of traumatic lumbar burst fractures. Short-segment pedicle screw instrumentation is a well described technique to reduce and stabilize thoracic and lumbar spine fractures. It is relatively a easy procedure but can only indirectly reduce a fractured vertebral body, and the means of augmenting the anterior column are limited. Hardware failure and a loss of reduction are recognized complications caused by insufficient anterior column support. Patients with traumatic lumbar burst fractures without neurologic deficits were included. After a short segment posterior reduction and fixation, bilateral transpedicular reduction of the endplate was performed using a balloon, and polymethyl methacrylate cement was injected. Pre-operative and post-operative central and anterior heights were assessed with radiographs and MRI. Sixteen patients underwent this procedure, and a substantial reduction of the endplates could be achieved with the technique. All patients recovered uneventfully, and the neurologic examination revealed no deficits. The postoperative radiographs and magnetic resonance images demonstrated a good fracture reduction and filling of the bone defect without unwarranted bone displacement. The central and anterior height of the vertebral body could be restored to 72 and 82% of the estimated intact height, respectively. Complications were cement leakage in three cases without clinical implications and one superficial wound infection. Posterior short-segment pedicle fixation in conjunction with balloon vertebroplasty seems to be a feasible option in the management of lumbar burst fractures, thereby addressing all the three columns through a single approach. Although cement leakage occurred but had no clinical consequences or neurological deficit.

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“…The gain in structural strength of the infiltrated vertebrae has been well documented through biomechanical tests [4,5,13,21]. It is generally accepted that cement infiltration (filling the trabecular bone cavities with bone cement) (a) strengthens vertebrae to withstand a higher axial compressive force prior to fracture, and (b) stiffens the augmented vertebra beyond its initial stiffness.…”

Section: Introductionmentioning

confidence: 99%