Mechanical characterisation of three percutaneous vertebroplasty biomaterials

Gheduzzi, S; Webb, Jason J C; Miles, A W

doi:10.1007/s10856-006-8469-6

Cited by 44 publications

(28 citation statements)

References 19 publications

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“…Cortoss Ò has a compressive strength of 91-179 MPa, with a shear strength of 8.4 MPa, which is significantly higher than PMMA bone cements [143,144]. The manufacturer's information also provides a Young's modulus of 6400 MPa and a tensile strength of 52 MPa; however, this has not been confirmed in other studies.…”

Section: Biomechanical Propertiesmentioning

confidence: 89%

Bone substitutes in the Netherlands – A systematic literature review

Stok¹,

Lieshout²,

El-Massoudi³

et al. 2011

Acta Biomaterialia

214

130

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Autologous bone grafting is currently considered as the gold standard to restore bone defects. However, clinical benefit is not guaranteed and there is an associated 8-39% complication rate. This has resulted in the development of alternative (synthetic) bone substitutes. The aim of this systematic literature review was to provide a comprehensive overview of literature data of bone substitutes registered in the Netherlands for use in trauma and orthopedic surgery. Brand names of selected products were used as search terms in three available databases: Embase, PubMed and Cochrane. Manuscripts written in English, German or Dutch that reported on structural, biological or biomechanical properties of the pure product or on its use in trauma and orthopedic surgery were included. The primary search resulted in 475 manuscripts from PubMed, 653 from Embase and 10 from Cochrane. Of these, 218 met the final inclusion criteria. Of each product, structural, biological and biomechanical characteristics as well as their clinical indications in trauma and orthopedic surgery are provided. All included products possess osteoconductive properties but differ in resorption time and biomechanical properties. They have been used for a wide range of clinical applications; however, the overall level of clinical evidence is low. The requirements of an optimal bone substitute are related to the size and location of the defect. Calcium phosphate grafts have been used for most trauma and orthopedic surgery procedures. Calcium sulphates were mainly used to restore bone defects after tumour resection surgery but offer minimal structural support. Bioactive glass remains a potential alternative; however, its use has only been studied to a limited extent.

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Section: Biomechanical Propertiesmentioning

confidence: 89%

Bone substitutes in the Netherlands – A systematic literature review

Stok¹,

Lieshout²,

El-Massoudi³

et al. 2011

Acta Biomaterialia

214

130

View full text Add to dashboard Cite

show abstract

“…Most of the studies in the literature are case reports and predominantly provide technical support for the special features of sacroplasty. The exact deposit of the cement in the sacrum is the main problem in sacroplasty [36], particularly to avoid neural injuries by exothermic reaction during hardening of extraosseous cement [21,28]. It is well known that the advantage of the kyphoplasty in the vertebral column over the vertebroplasty is the reduction of cement leakage [27].…”

Section: Discussionmentioning

confidence: 99%

Sacroplasty in a cadaveric trial: comparison of CT and fluoroscopic guidance with and without balloon assistance

et al. 2009

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Sacral insufficiency fractures can cause severe, debilitating pain to patients concerned. The incidence of this fracture type correlates with the appearance of osteoporosis in the elderly population. A polymethylmethacrylate (PMMA) cement injection procedure called sacroplasty has been recently described as an optional method for the treatment of this fracture type. However, the correct cement placement in the complex anatomical structure of the sacrum is a surgical challenge. The aim of the study is to compare the precision, safety, and radiation exposure of standard multiplanar fluoroscopy and computed tomography (CT) guidance for PMMA application to the sacrum using both balloon-assisted sacroplasty and conventional sacroplasty. A controlled experimental investigation in a human cadaver trial has been performed. Two imaging and two application modalities to monitor percutaneous PMMA injection to the sacrum were examined. The application forms were randomized from side to side of the pelvis. We found less cement extravasation in the CT-guided groups, but also a significant higher radiation exposure (P \ 0.05) by using CT guidance. The conventional fluoroscopy-guided sacroplasty revealed the shortest procedure time (incision to closure time) of all treatment groups (P \ 0.01). These findings show no difference regarding cement extravasation between ballonassisted and conventional sacroplasty. Further, in comparison to fluoroscopy-assisted technique, the CT-guided cement injection seems to decrease the risk of cement extravasation, irrespective of the use of an additional balloon assistance. However, we have to consider a greater radiation exposure using CT guidance. Further investigations will proof the suitability in the normal course of clinical life.

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“…Furthermore, some calcium phosphate cements are being investigated in experimental and clinical settings. Composite cements and calcium phosphate cements will probably improve the integration of the material into the trabecular matrix and will hopefully overcome some of the disadvantages of the PMMA cement, which should improve stability and functionality of the treated spine over time [32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Height gain of vertebral bodies and stabilization of vertebral geometry over one year after vertebroplasty of osteoporotic vertebral fractures

Pitton¹,

Morgen²,

Herber³

et al. 2007

Eur Radiol

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The height gain of vertebral bodies after vertebroplasty and geometrical stability was evaluated over a one-year period. Osteoporotic fractures were treated with vertebroplasty. The vertebral geometry and disc spaces were analysed using reformatted computed tomography (CT) images: heights of the anterior, posterior, and lateral vertebral walls, disc spaces, endplate angles, and minimal endplate distances. Vertebrae were assigned to group I [severe compression (anterior height/posterior height) <0.75] and group II (moderate compression index >0.75). A total of 102 vertebral bodies in 40 patients (12 men, 28 women, age 70.3 +/- 9.5) were treated with vertebroplasty and prospectively followed for 12 months. Group I showed a greater benefit compared with group II with respect to anterior height gain (+2.1 +/- 1.9 vs +0.7 +/- 1.6 mm, P < 0.001), reduction of endplate angle (-3.6 +/- 4.2 vs -0.8 +/- 2.3 degrees , P < 0.001), and compression index (+0.09 +/- 0.11 vs +0.01 +/- 0.06, P < 0.001). At one-year follow-up, group I demonstrated preserved anterior height gain (+1.5 +/- 2.8 mm, P < 0.015) and improved endplate angle (-3.4 +/- 4.9 degrees , P < 0.001). In group II, the vertebral heights returned to and were fixed at the pre-interventional levels. Vertebroplasty provided vertebral height gain over one year, particularly in cases with severe compression. Vertebrae with moderate compression were fixed and stabilized at the pre-treatment level over one year.

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Mechanical characterisation of three percutaneous vertebroplasty biomaterials

Cited by 44 publications

References 19 publications

Bone substitutes in the Netherlands – A systematic literature review

Bone substitutes in the Netherlands – A systematic literature review

Sacroplasty in a cadaveric trial: comparison of CT and fluoroscopic guidance with and without balloon assistance

Height gain of vertebral bodies and stabilization of vertebral geometry over one year after vertebroplasty of osteoporotic vertebral fractures

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