Response of fractured osteoporotic bone to polymethylmethacrylate after vertebroplasty: case report

Kim, Choll W.; Minocha, Jeet; Wahl, Carter E.; Garfin, Steven R.

doi:10.1016/j.spinee.2004.05.002

Cited by 13 publications

(9 citation statements)

References 15 publications

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“…Bone tissue reaction to PMMA was characterized by a thin fibrous tissue layer and occasional foreign‐body reactions, which is similar to histological observations reported from vertebral bodies retrieved from human patients6–8 and after experimental vertebral cement augmentation 11, 35–37. The foreign‐body reaction seemed to be a response to barium sulfate rather than to PMMA, because foreign‐body giant cells were associated with aggregates of barium sulfate particles, and the cells contained phagocytosed barium sulfate particles.…”

Section: Discussionsupporting

confidence: 81%

“…Currently, polymethylmethacrylate (PMMA) is the most commonly used material for vertebral body cement augmentation. Histologic evaluation of retrieved human vertebral bodies after cement augmentation has revealed bone necrosis and foreign body reaction in the vicinity of the PMMA cement and a fibrous membrane surrounding it 6–8. Toxic effects of the methylmethacrylate monomer9, 10 or the contrast agent (barium sulfate)11 or the exothermic curing process12, 13 may be the cause of tissue damage.…”

Section: Introductionmentioning

confidence: 99%

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Effect of vertebral cement augmentation with polymethylmethacrylate on intervertebral disc and bone tissue

et al. 2011

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Vertebral cement augmentation is reported to be a safe and effective technique for providing stabilization and pain relief. However, adjacent intervertebral discs may be at risk of accelerated degeneration as a result of aggravated nutritional constraints. Therefore, we investigated the effects of injecting polymethylmethacrylate (PMMA) into three adjacent lumbar vertebrae on intervertebral disc and vertebral bone tissue in 12 skeletally mature sheep. After 6 and 12 months of augmentation, the sheep were euthanized and their spines were processes for histological evaluation. Semiquantitative histomorphological analysis of discs and endplates was conducted using published criteria. Histomorphological changes in the augmented bone were assessed qualitatively. Approximately 80% of the length of the endplates was in contact with PMMA. However, there was no significant difference between the histopathological score of the discs adjacent to augmented vertebrae and the score of the control discs. Bone tissue reaction to PMMA was characterized by a thin fibrous tissue layer and occasional foreign-body reactions. New bone formation was present in all augmented vertebrae. Concerns about aggravation of disc degeneration as a result of vertebral cement augmentation seem to be unsubstantiated. Furthermore, adverse effects of PMMA cement on bone biology do not seem to be a relevant issue.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Effect of vertebral cement augmentation with polymethylmethacrylate on intervertebral disc and bone tissue

et al. 2011

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“…Togawa et al34 found a few small areas of necrotic bone tissue and foreign body reaction around the PMMA in 4 vertebral bodies of 2 patients, obtained 1 month and 2 years, respectively, after the vertebroplasty/ kyphoplasty. Kim et al35 showed scattered necrotic bone tissue in a vertebra of a patient that had recently undergone vertebroplasty with PMMA.…”

mentioning

confidence: 99%

Early Histologic Changes Following Polymethylmethacrylate Injection (Vertebroplasty) in Rabbit Lumbar Vertebrae

Urrutia

Bono²,

Mery³

et al. 2008

Spine

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“…20,21 Influences of bone cement on intervertebral disc cells are still unknown, and clinical relations of intradiscal cement leakage are even less reported. 22,23 The aim of this study was to determine the effect of three types of vertebroplasty filler materials-PMMA, CSC, CPC-on the viability and gene expression of isolated nucleus pulposus cells.…”

Section: Introductionmentioning

confidence: 99%

Effect of vertebroplasty filler materials on viability and gene expression of human nucleus pulposus cells

Lazáry

Szabó

Varga

et al. 2008

Journal Orthopaedic Research

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Consequences of intradiscal cement leakage-often occurring after vertebral cement augmentation for the treatment of vertebral compression fractures-are still unknown. In this study, we have investigated the influences of vertebroplasty filler materials (polymethylmethacrylate-, calcium phosphate-and calcium sulfate-based bone cement) on isolated nucleus pulposus cells. Cell viability of cultured human nucleus pulposus cells were measured after treatment with vertebroplasty filler materials. Gene expression profile of selected genes was determined with quantitative real-time PCR. The widely used polymethylmethacrylate and calcium phosphate cement significantly decreased cell number in a dose-and time-dependent manner while calcium sulfate cement affected cell viability less. Expression of genes involved in matrix metabolism of nucleus pulposus-aggrecan, collagens, small proteoglycans-as well as important transcription factors have also significantly changed due to treatment (e.g., 2.5-fold decrease in aggrecan expression was determined in cultures due to polymethylmethacrylate treatment). Our results suggest that vertebroplasty filler materials-depending on the type of applied material-can accelerate the degeneration of nucleus pulposus cells resulting in a less flexible disc in case of intradiscal cement leakage. This process may increase the risk of a subsequent new vertebral fracture, the main complication of vertebral augmentation. ß

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Response of fractured osteoporotic bone to polymethylmethacrylate after vertebroplasty: case report

Cited by 13 publications

References 15 publications

Effect of vertebral cement augmentation with polymethylmethacrylate on intervertebral disc and bone tissue

Effect of vertebral cement augmentation with polymethylmethacrylate on intervertebral disc and bone tissue

Early Histologic Changes Following Polymethylmethacrylate Injection (Vertebroplasty) in Rabbit Lumbar Vertebrae

Effect of vertebroplasty filler materials on viability and gene expression of human nucleus pulposus cells

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