Biomechanics of low-modulus and standard acrylic bone cements in simulated vertebroplasty: A human ex vivo study
2015 (English)In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 48, no 12, 3258-3266 p.Article in journal (Refereed) Published
The high stiffness of bone cements used in vertebroplasty has been hypothesised to contribute to the propensity of adjacent vertebral fractures after treatment. Therefore, new low-modulus cements have been developed; however, there are currently no studies assessing the biomechanical aspects of vertebroplasty with these cements in an ex vivo non-prophylactic model. In this study, we induced wedge fractures through eccentric uniaxial compression to single whole-vertebrae, before and after augmentation with either standard or low-modulus cement. Compressive strength and stiffness of individual vertebrae were measured, on 19 samples from metastatic spines and 20 samples from elderly, osteopenic spines. While both cement types increased the strength of both the metastatic (+34% and +63% for standard and low-modulus cement, respectively) and the elderly vertebrae (+303% and +113%, respectively), none of them restored the initial stiffness of metastatic specimens (−51% and −46%, respectively). Furthermore, low-modulus cement gave a lower total stiffness (−13%) of elderly specimens whereas standard cement increased it above initial levels (+17%). Results show that vertebroplasty with low-modulus cement could provide restoration of the initial stiffness while increasing the strength of fractured elderly vertebrae and hence represent a treatment modality which is closer to pre-augmented behaviour. Also, this study indicates that stiffness-modified cement needs to be optimised for patient/pathology specific treatment.
Place, publisher, year, edition, pages
2015. Vol. 48, no 12, 3258-3266 p.
vertebroplasty, PMMA, low-modulus cement(s), adjacent vertebral fracture(s), osteoporosis, metastasis, wedge compression fracture(s)
Biomaterials Science Engineering and Technology
Research subject Engineering Science with specialization in Materials Science
IdentifiersURN: urn:nbn:se:uu:diva-213226DOI: 10.1016/j.jbiomech.2015.06.026ISI: 000363069900045OAI: oai:DiVA.org:uu-213226DiVA: diva2:681330
FunderEU, FP7, Seventh Framework ProgrammeVINNOVA, VINNMER 2010-02073