Chinese Journal of Tissue Engineering Research ›› 2018, Vol. 22 ›› Issue (2): 171-177.doi: 10.3969/j.issn.2095-4344.0002

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Effects of percutaneous vertebroplasty with different bone cement volumes on the adjacent intervertebral disc in a rabbit model of osteoporosis  

Zhang Han-xiang, Fan Hua-hua, Cai Xiao-jun
  

  1. Department of Orthopedics, the Third Affiliated Hospital of Zunyi Medical University (the First People’s Hospital of Zunyi, Zunyi 563000, Guizhou Province, China
  • Received:2017-08-06 Online:2018-01-18 Published:2018-01-18
  • Contact: Fan Hua-hua, Master, Attending physician, Department of Orthopedics, the Third Affiliated Hospital of Zunyi Medical University (the First People’s Hospital of Zunyi, Zunyi 563000, Guizhou Province, China
  • About author:Zhang Han-xiang, Master, Attending physician, Department of Orthopedics, the Third Affiliated Hospital of Zunyi Medical University (the First People’s Hospital of Zunyi, Zunyi 563000, Guizhou Province, China
  • Supported by:
    the Joint Foundation of the First People’s Hospital of Zunyi & Zunyi Municipal Department of Science and Technology, No. (2011)21

Abstract:

BACKGROUND: With the development of clinical practices, some complications of vertebroplasty are gradually highlighted. Considering the thermal reaction, toxicity and space-occupying filling of bone cement, vertebroplasty with bone cement injection is likely to cause some impacts on the surrounding vertebrae, especially the adjacent ones. However, little is reported on the effect of different volumes of bone cement on degeneration of the adjacent vertebrae.
OBJECTIVE: To determine the effects of different bone cement volumes in percutaneous vertebroplasty on adjacent intervertebral discs in a rabbit model of osteoporosis.
METHODS: Thirty 5-month-old New Zealand rabbits were randomly assigned into five groups: sham, iohexol, low-dose bone cement, middle-dose bone cement and high-dose bone cement groups. Osteoporosis models were established by ovariectomy combined with glucocorticoid injection. After modeling, sham puncture at the fifth lumbar vertebrae was done in the sham group, and true puncture at the fifth lumber vertebra was done in the iohexol group followed by injection with 0.2 mL of iohexol. Different volumes of bone cement (0.1, 0.2, 0.3 mL) were injected in the low-, middle- and high-dose bone cement groups, respectively. After 12 weeks, rabbits in these three groups were killed to take the intact L4-5 segments that were divided into two parts: one for TUNEL staining to observe cell apoptosis and to calculate apoptotic index, and the other for real-time PCR detection of relative expression of interleukin-1, type II collagen and matrix metalloproteinase-7.
RESULTS AND CONCLUSION: The cell apoptosis index in the low-, middle- and high-dose bone cement groups were significantly different from that in the sham and iohexol groups, but there was no significant difference among three bone cement groups. The relative expression of interleukin-1 mRNA showed a significant difference between the high-dose group and sham group. The relative expression of type II collagen and matrix metalloproteinase-7 in the three bone cement groups was significantly different from that in the sham and iohexol groups, and the expression in the high-dose bone cement group was also significantly different from that in the low- and middle-dose bone cement groups. To conclude, after percutaneous vertebroplasty, injected bone cement certainly impacts the adjacent vertebrae in the rabbit model of osteoporosis, but not in a dose-dependent manner. Moreover, a dramatic aggravation of degeneration of the adjacent vertebrae is developed when high-dose bone cement is injected.

Key words: Intervertebral Disk, Vertebroplasty, Osteoporosis

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