Filler Materials Used in Kyphoplasty and Vertebroplasty for Osteoporotic Vertebral Compression Fractures

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Osteoporosis is the most common metabolic bone disease and the most common cause of fractures in older adults. Vertebral compression fracture (VCF) is the most common complication in patients with osteoporosis. At present, vertebroplasty (VP) and kyphoplasty (KP) are two minimally invasive techniques used to treat osteoporotic vertebral compression fractures. In clinical use, KP and VP have stable and reliable therapeutic effects. However, there are still some complications and issues surrounding KP and VP application, and for long-term clinical follow-up. Thus, it is important to continue to improve the technology of the filler materials used in KP and VP in order to evolve the biomechanical characteristics of the postoperative vertebra, and to reduce the incidence of complications. The filler materials used for both techniques require good biocompatibility, good biomechanical strength and stiffness, and good radiopacity for the fluoroscopy guided procedures. PMMA and new filler materials (calcium phosphate cement, calcium sulfate cement, composite materials) are now available for clinical use. In this review paper, we will focus on the issues and characteristics of these filler materials.

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Periodical:

Advanced Materials Research (Volumes 393-395)

Edited by:

Ran Chen and Wen-Pei Sung

Pages:

766-771

Citation:

B. Zhang and M. Dai, "Filler Materials Used in Kyphoplasty and Vertebroplasty for Osteoporotic Vertebral Compression Fractures", Advanced Materials Research, Vols. 393-395, pp. 766-771, 2012

Online since:

November 2011

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$41.00

[1] Rockville: Bone health and osteoporosis: a report of the Surgeon General(2004).

[2] B.P. Lukert: Vertebral compression fractures: how to manage pain, avoid disability. Geriatrics Vol. 49(1994), pp.22-26.

[3] P.J. Meunier, P.D. Delmas and R. Eastell: Diagnosis and management of osteoporosis in postmenopausal women: clinical guidelines. International Committee for Osteoporosis Clinical Guidelines. Clin Ther Vol. 21(1999), pp.1025-1044.

DOI: https://doi.org/10.1016/s0149-2918(99)80022-8

[4] F.M. Phillips, B.A. Pfeifer and I.H. Lieberman: Minimally invasive treatments of osteoporotic vertebral compression fractures: vertebroplasty and kyphoplasty. Instr Course Lect Vol. 52(2003), pp.559-567.

[5] W.C.G. Peh, L.A. Gilula and D.D. Peck: Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology Vol. 223 (2002), p.121–126.

DOI: https://doi.org/10.1148/radiol.2231010234

[6] R. Scroop, J. Eskridge and G.W. Britz: Paradoxicalcerebral arterial embolization of cement during intraoperative vertebroplasty: case report. AJNR Am J Neuroradiol Vol. 23 (2002), p.868–870.

[7] A.P. Higueras, L. Alvarez and R.E. Rossi: Percutaneous vertebroplasty: long term clinical and radiological outcome. Neuroradiology Vol. 44(2002), p.950–954.

DOI: https://doi.org/10.1007/s00234-002-0856-1

[8] J.T. Ledlie, M. Renfro: Balloon kyphoplasty: one-year outcomes in vertebral body height restoration, chronic pain, and activity levels. J Neurosurg Vol. 98(2003), p.36–42.

DOI: https://doi.org/10.3171/spi.2003.98.1.0036

[9] J.V. Coumans, M.K. Reinhardt and I.H. Lieberman: Kyphoplasty for vertebral compression fractures: 1-year clinical outcomes from a prospective study. J Neurosurg Vol. 99(2003), p.44–50.

DOI: https://doi.org/10.3171/spi.2003.99.1.0044

[10] S.R. Garfin, H.A. Yuan and M.A. Reiley: New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine Vol. 26(2001), p.1511–1515.

DOI: https://doi.org/10.1097/00007632-200107150-00002

[11] D. Togawa, T.W. Bauer and I.H. Lieberman: Histologic evaluation of human vertebral bodies after vertebral augmentationwith polymethylmethacrylate. Spine Vol. 28(2003), p.1521–1527.

DOI: https://doi.org/10.1097/01.brs.0000076825.12630.3c

[12] J. Bernhard, P.F. Heini and P.M. Villiger: Asymptomatic diffuse pulmonary embolism caused by acrylic cement: an unusual complication of percutaneous vertebroplasty. Ann Rheum Dis Vol. 62 (2003), p.85–86.

DOI: https://doi.org/10.1136/ard.62.1.85

[13] R. Scroop, J. Eskridge and G.W. Britz: Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: case report. AJNR Am J Neuroradiol Vol. 23(2002), p.868–870.

[14] S.M. Belkoff, S. Molloy: Temperature measurement during polymerization of polymethylmethacrylate cement used for vertebroplasty. Spine Vol. 28 (2003), p.1555–1559.

DOI: https://doi.org/10.1097/01.brs.0000076829.54235.9f

[15] M. Nakano, N. Hirano, K. Matsuura: Percutaneous trans-pedicular vertebroplasty with calcium phosphate cement in the treatment of osteoporotic vertebral compression and burst fractures. J Neurosurg Vol. 97 (2002), p.287–293.

DOI: https://doi.org/10.3171/spi.2002.97.3.0287

[16] S. Larsson, T.W. Bauer: Use of injectable calcium phosphate cement for fracture fixation: a review. Clin Orthop (2002), p.23–32.

[17] E.P. Frankenburg, S.A. Goldstein and T.W. Bauer: Biomechanical and histological evaluation of a calcium phosphate cement. J Bone Joint Surg Am Vol. 80(1998), p.1112–1124.

[18] T.A. Schildhauer, T.W. Bauer and C. Josten: Open reduction and augmentation of internal fixation with an injectable skeletal cement for the treatment of complex calcaneal fractures. J Orthop Trauma Vol. 14(2000), p.309–317.

DOI: https://doi.org/10.1097/00005131-200006000-00001

[19] T.M. Turner, R.M. Urban and T.H. Lim: Vertebroplasty using injectable calcium phosphate cement compared to polymethylmethacrylate in a unique canine vertebral body large defectmodel. Trans 49th Annual Meeting of Orthopaedic Research Society; New Orleans. p.267(2003).

DOI: https://doi.org/10.1016/j.spinee.2006.12.007

[20] S. Takikawa, T.W. Bauer and A.S. Turner: Comparison of injectable calcium phosphate cement and polymethylmethacrylate for use in vertebroplasty: in-vivo evaluation using an osteopenic sheep model. Presented at the 28th Annual Meeting of the Society of Biomaterials. Tampa, FL, p.231(abstr. ) (2002).

[21] T.H. Lim, G.T. Brebach and S.M. Renner: Biomechanical evaluation of an injectable calcium phosphate cement for vertebroplasty. Spine Vol. 27 (2002), p.1297–1302.

DOI: https://doi.org/10.1097/00007632-200206150-00010

[22] P.F. Heini, U. Berlemann, and M. Kaufmann: Augmentation of mechanical properties in osteoporotic vertebral bonesa biomechanical investigation of vertebroplasty efficacy with different bone cements. Eur Spine J Vol. 10 (2001), p.164–171.

DOI: https://doi.org/10.1007/s005860000204

[23] S. Tomita, A. Kin and M. Yazu: Biomechanical evaluation of kyphoplasty and vertebroplasty with calcium phosphate cement in a simulated osteoporotic compression fracture. J Orthop Sci Vol. 8 (2003), p.192–197.

DOI: https://doi.org/10.1007/s007760300032

[24] P.F. Heini, U. Berlemann: Bone substitutes in vertebroplasty. Eur Spine J Vol. 10(2001), p.205–213.

[25] D. Sauter, L. Goldfrank, B.D. Charash: Cardiopulmonary arrest following an infusion of calcium 2-amino ethanol phosphate. J Emerg Med Vol. 8(1990), p.717–720.

DOI: https://doi.org/10.1016/0736-4679(90)90285-4

[26] A. Henschel, L. Dannenberg, U. Gobel: Disseminated ischemic necrosis and livedo racemosa in a chronic dialysis patient with calciphylaxis. Hautarzt Vol. 50 (1999), p.439–444.

DOI: https://doi.org/10.1007/s001050050939

[27] N. Goto, H. Kato and J. Maeyama: Local tissue irritating effects and adjuvant activities of calcium phosphate and aluminium hydroxide with different physical properties. Vaccine Vol. 15(1997), p.1364–1371.

DOI: https://doi.org/10.1016/s0264-410x(97)00054-6

[28] J.A. Hamilton, R. Byrne and G. Whitty: Particulate adjuvants can induce macrophage survival, DNA synthesis, and a synergistic proliferative response toGM-CSF and CSF-1. J Leukoc Biol Vol. 67(2000), p.226–232.

[29] T.H. Lim, G.T. Brebach and S.M. Renner: Biomechanical evaluation of an injectable calcium phosphate cement for vertebroplasty. Spine Vol. 27 (2002), p.1297–1302.

DOI: https://doi.org/10.1097/00007632-200206150-00010

[30] T.M. Turner, R.M. Urban and S. Gitelis: Resorption evaluation of a large bolus of calcium sulfate in a canine medullary defect. Orthopedics Vol. 26(2003), p.577–579.

[31] P.A. Glazer, U.M. Spencer and R.N. Alkalay: In vivo evaluation of calcium sulfate as a bone graft substitute for lumbar spinal fusion. Spine Vol. 1(2001), p.395–401.

DOI: https://doi.org/10.1016/s1529-9430(01)00108-5

[32] W.R. Walsh, P. Morberg, Y. Yu: Response of a calcium sulfate bone graft substitute in a confined cancellous defect. Clin Orthop Vol. 406(2003), p.228–236.

DOI: https://doi.org/10.1097/00003086-200301000-00033

[33] X.S. Zhu, X.Q. Chen and C.M. Chen: Evaluation of calcium phosphate and calcium sulfate as injectable bone cements in sheep vertebrae. J Spinal Disord Tech Vol. 00(2011), pp.1-5.

[34] M. DiCicco, R. Compton and S.A. Jansen-Varnum : In vitro evaluation of orthopedic composite cytotoxicity: assessing the potential for postsurgical production of hydroxyl radicals. J Biomed Mater Res Vol. 70B(2004), p.1–20.

DOI: https://doi.org/10.1002/jbm.b.30127

[34] E.M. Erbe, T.D. Clineff and G. Gualtieri: Comparison of a new bisphenola-glycidyl dimethacrylate-based cortical bone void filler with polymethyl methacrylate. Eur Spine J Vol. 10 (2001), p.147–152.

DOI: https://doi.org/10.1007/s005860100288