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Article: Bioactive bone cement as a principal fixture for spinal burst fracture: An in vitro biomechanical and morphologic study

TitleBioactive bone cement as a principal fixture for spinal burst fracture: An in vitro biomechanical and morphologic study
Authors
Issue Date2001
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2001, v. 26 n. 24, p. 2684-2690 How to Cite?
AbstractStudy Design. An in vitro biomechanical and radiographic study to evaluate the properties of a newly developed bioactive bone cement for stabilization of the fractured spine, suitable for minimally invasive application. Objectives. To determine the mechanical stability of the fractured spine after injection of the newly developed bioactive bone cement under quasi-static and cyclic loading regimens. Summary of Background Data. Bone cement injection has been reported as a potentially useful, minimally invasive technique for treating vertebral body fracture or stabilizing osteoporosis. However, potential problems associated with the use of polymethylmethacrylate (PMMA) have prompted the search for alternative solutions. The use of bioactive bone cement as a potential replacement for PMMA has been reported. Methods. Biomechanical and radiographic analyses were used to test the mechanical stability of the fractured spine. The cement used was formed from hydroxyapatite powder containing strontium and bisphenol A diglycidylether dimethacrylate (D-GMA) resin. Twenty-six fresh porcine spine specimens (T10-L1) were divided into three groups: pilot, intact, and cemented. Spinal stiffness and failure strength were recorded in the intact group with the specimens flexed at 10°. Uniform injuries were created in all specimens of the cemented group, and compressive loading was applied with 10° of flexion until a fracture occurred. The bone cement was injected into the fractured spine, and stiffness was evaluated after 1 hour. Failure strength was also recorded after 3000 and 20,000 fatigue load cycles. Morphology of the specimens was observed and evaluated. Results. Results from a cell biocompatibility test indicated that the new bioactive bone cement was favorable for cell growth. Spinal stiffness significantly decreased after fracture (47.5% of intact condition). Instant stiffness of the spine recovered to 107.8% of the intact condition after bone cement injection. After 3000 and 20,000 cycles of fatigue loading, stiffness of the cemented spine was found to be 93.5% and 94.4% of intact stiffness, respectively (P<0.05). Average failure strength of the spine was 5056 N (after 3000 cycles) and 5301 N (after 20,000 cycles) after bone cement injection and fatigue loading. Radiographs and cross-sectional observations indicated a good cement-bone bonding and fracture fill. Conclusions. A new bioactive bone cement without cytotoxic effect has been developed. Results show that minimally invasive techniques to apply this cement to porcine spines results in augmentation of mild burst fractures such that the original stiffness and strength of the vertebra are recovered. This new cement therefore shows potential as an augmentation to traditional instrumentation in the surgical management of vertebral fractures. The potential for further clinical applications is currently under investigation.
Persistent Identifierhttp://hdl.handle.net/10722/170040
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLu, WWen_US
dc.contributor.authorC Cheung, KMen_US
dc.contributor.authorLi, YWen_US
dc.contributor.authorK Luk, KDen_US
dc.contributor.authorHolmes, ADen_US
dc.contributor.authorZhu, QAen_US
dc.contributor.authorY Leong, JCen_US
dc.date.accessioned2012-10-30T06:04:53Z-
dc.date.available2012-10-30T06:04:53Z-
dc.date.issued2001en_US
dc.identifier.citationSpine, 2001, v. 26 n. 24, p. 2684-2690en_US
dc.identifier.issn0362-2436en_US
dc.identifier.urihttp://hdl.handle.net/10722/170040-
dc.description.abstractStudy Design. An in vitro biomechanical and radiographic study to evaluate the properties of a newly developed bioactive bone cement for stabilization of the fractured spine, suitable for minimally invasive application. Objectives. To determine the mechanical stability of the fractured spine after injection of the newly developed bioactive bone cement under quasi-static and cyclic loading regimens. Summary of Background Data. Bone cement injection has been reported as a potentially useful, minimally invasive technique for treating vertebral body fracture or stabilizing osteoporosis. However, potential problems associated with the use of polymethylmethacrylate (PMMA) have prompted the search for alternative solutions. The use of bioactive bone cement as a potential replacement for PMMA has been reported. Methods. Biomechanical and radiographic analyses were used to test the mechanical stability of the fractured spine. The cement used was formed from hydroxyapatite powder containing strontium and bisphenol A diglycidylether dimethacrylate (D-GMA) resin. Twenty-six fresh porcine spine specimens (T10-L1) were divided into three groups: pilot, intact, and cemented. Spinal stiffness and failure strength were recorded in the intact group with the specimens flexed at 10°. Uniform injuries were created in all specimens of the cemented group, and compressive loading was applied with 10° of flexion until a fracture occurred. The bone cement was injected into the fractured spine, and stiffness was evaluated after 1 hour. Failure strength was also recorded after 3000 and 20,000 fatigue load cycles. Morphology of the specimens was observed and evaluated. Results. Results from a cell biocompatibility test indicated that the new bioactive bone cement was favorable for cell growth. Spinal stiffness significantly decreased after fracture (47.5% of intact condition). Instant stiffness of the spine recovered to 107.8% of the intact condition after bone cement injection. After 3000 and 20,000 cycles of fatigue loading, stiffness of the cemented spine was found to be 93.5% and 94.4% of intact stiffness, respectively (P<0.05). Average failure strength of the spine was 5056 N (after 3000 cycles) and 5301 N (after 20,000 cycles) after bone cement injection and fatigue loading. Radiographs and cross-sectional observations indicated a good cement-bone bonding and fracture fill. Conclusions. A new bioactive bone cement without cytotoxic effect has been developed. Results show that minimally invasive techniques to apply this cement to porcine spines results in augmentation of mild burst fractures such that the original stiffness and strength of the vertebra are recovered. This new cement therefore shows potential as an augmentation to traditional instrumentation in the surgical management of vertebral fractures. The potential for further clinical applications is currently under investigation.en_US
dc.languageengen_US
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_US
dc.relation.ispartofSpineen_US
dc.subject.meshAnimalsen_US
dc.subject.meshBiocompatible Materialsen_US
dc.subject.meshBiomechanicsen_US
dc.subject.meshBone Cements - Chemistry - Toxicityen_US
dc.subject.meshDurapatiteen_US
dc.subject.meshEquipment Designen_US
dc.subject.meshMaterials Testingen_US
dc.subject.meshMethacrylatesen_US
dc.subject.meshSpinal Fractures - Radiography - Surgeryen_US
dc.subject.meshSpinal Fusion - Methodsen_US
dc.subject.meshStress, Mechanicalen_US
dc.subject.meshStrontiumen_US
dc.subject.meshSwineen_US
dc.titleBioactive bone cement as a principal fixture for spinal burst fracture: An in vitro biomechanical and morphologic studyen_US
dc.typeArticleen_US
dc.identifier.emailLu, WW:wwlu@hku.hken_US
dc.identifier.emailC Cheung, KM:cheungmc@hku.hken_US
dc.identifier.emailK Luk, KD:hcm21000@hku.hken_US
dc.identifier.authorityLu, WW=rp00411en_US
dc.identifier.authorityC Cheung, KM=rp00387en_US
dc.identifier.authorityK Luk, KD=rp00333en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1097/00007632-200112150-00010en_US
dc.identifier.pmid11740355-
dc.identifier.scopuseid_2-s2.0-0035893684en_US
dc.identifier.hkuros71311-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035893684&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume26en_US
dc.identifier.issue24en_US
dc.identifier.spage2684en_US
dc.identifier.epage2690en_US
dc.identifier.isiWOS:000173082200009-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLu, WW=7404215221en_US
dc.identifier.scopusauthoridC Cheung, KM=7402406754en_US
dc.identifier.scopusauthoridLi, YW=7502084099en_US
dc.identifier.scopusauthoridK Luk, KD=7201921573en_US
dc.identifier.scopusauthoridHolmes, AD=7401687268en_US
dc.identifier.scopusauthoridZhu, QA=7403313141en_US
dc.identifier.scopusauthoridY Leong, JC=35560782200en_US

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