CT volumetry of intravertebral cement after kyphoplasty. Comparison of polymethylmethacrylate and calcium phosphate in a 12-month follow-up

Abstract

This study was intended to measure the volume of intravertebral cement after balloon kyphoplasty with high resolution computed tomography (CT) and dedicated software. Volume changes of biocompatible calcium phosphate cement (CPC) were detected during a follow-up of 12 months. Measurements were compared with a control group of patients treated with polymethylmethacrylate (PMMA). Twenty-three vertebrae (14 CPC, 9 PMMA) of 12 patients were examined with CT using an identical imaging protocol. Dedicated software was used to quantify intravertebral cement volume in subvoxel resolution by analyzing each cement implant with a density-weighted algorithm. The mean volume reduction of CPC was 0.08 ml after 12 months, which corresponds to an absorption rate of 2 vol%. However, the difference did not reach significance level (P>0.05). The mean error estimate was 0.005 ml, indicating excellent precision of the method. CT volumetry appears a precise tool for measurement of intravertebral cement volume. CT volumetry offers the possibility of in vivo measurement of CPC resorption.

Kyphosis reduction and the rate of cement leaks after vertebroplasty of intravertebral clefts

“…Despite the fact that vertebroplasty and kyphoplasty seem to produce similar clinical results in the treatment of osteoporotic vertebral compression fractures, there might be advantages for kyphoplasty in the treatment of traumatic vertebral compression fractures in younger patients when local kyphosis reduction is desirable [27]. But in those cases, a biocompatible cement should be favored above PMMA [28]. To enable a better comparison of kyphosis reduction by vertebroplasty and kyphoplasty, a prospective study comparing both procedures should be performed.…”

Percutaneous vertebroplasty and kyphoplasty for the stand‐alone augmentation of osteoporosis‐induced vertebral compression fractures: Present status and future directions

“…102 As results from more clinical studies in which injectable bone cements other than PMMA-based ones and CaPs are used become available, it should be possible to make more definitive statements on this issue.…”

Design of ceramic-based cements and putties for bone graft substitution

“…When all these measurements are considered, it becomes very clear that CPCs and calcium sulphate cements can only be applied in non-load-bearing applications. The poor mechanical properties of CPCs explain why CPCs are not even performing well in applications where low load-bearing properties are required, for example in bone augmentation (Blattert et al, 2006;Libicher et al, 2006;Libicher et al, 2005;Maestretti et al, 2007;Nakano et al, 2005;Nakano et al, 2002).…”