Biphasic calcium composite bone cement with a negative surface charge used in vertebroplasty

doi:10.3969/j.issn.2095-4344.2014.12.001

Abstract

Abstract:

BACKGROUND: A newly developed calcium phosphate/β-tricalcium phosphate composite bone cement with a negative surface charge (genex®) has been reported to possess osteoinductivity properties. However, to our knowledge, no previous literatures have reported genex® for vertebroplasty in the osteoporotic spine.
OBJECTIVE: To evaluate the biomechanical properties and osteogenesis of vertebral bodies injected with genex® cement in a rabbit vertebroplasty defect model.
METHODS: Thirty New Zealand rabbits were used to establish osteoporosis models. Four weeks after modeling, model rabbits had an iatrogenically created cavitary lesion at L3 and L5 and were injected with either genex® cement (experimental group) or polymethyl methacrylate bone cement (control group). The L1 vertebral body served as model group without treatment. After 3 and 6 months, 15 rats from each group were executed respectively, and three vertebral samples were taken for Micro-CT analysis and biomechanical tests.
RESULTS AND CONCLUSION: (1) The Micro-CT showed better three-dimensional structure parameters of the trabecular bone in the experimental group than the control group (P < 0.05) after 3 months, which however had no difference from the model group (P > 0.05). After 6 months, the structure parameters in the experimental group were superior to those in the control and model groups (P < 0.05). (2) After 3 months, the vertebral body compression strength of the experimental group was lower than that of the control group (P < 0.05), but higher than that in the model group (P < 0.05). The vertebral stiffness of the experimental group was lower than that in control and model groups (P < 0.05). After 6 months, the vertebral body compression strength of the experimental group was not different from that of the control group (P > 0.05), but still higher than that of the model group (P < 0.05). The vertebral stiffness showed no difference between three groups (P > 0.05). These findings indicate that genex® cement can rapidly repair osteoporotic vertebral defects and improve the bone strength. Verterbroplasty with genex® cement has adequate osteoinductivity, biocompatibility, and adequate compressive strength.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: biocompatible materials, vertebroplasty, osteoporosis, biomechanics

CLC Number:

R318

Zhang Shu-fang, Chen Rong-chun, Jiang Jian-ming, Zhu Qing-an. Biphasic calcium composite bone cement with a negative surface charge used in vertebroplasty[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(12): 1805-1810.

Figures/Tables 2

References

[1] Galibert P,Deramont H,Rosat P,et al.Note préliminaire sur le traitement des angiomes vertébraux par vertébroplastie percutanée acrylique. Neurochirurgie.1987; 33(2):166-168.

[2] Garfin SR,Yuan HA,Reiley MA.New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures.Spine (Phila Pa 1976). 2001;26(4):1511-1515.

[3] Hanley E,Green NE,Spengler DM.An AOA critical issue. Less invasive procedures in spine surgery.J Bone Joint Surg Am. 2003;85(5):956-961.

[4] Alvarez L,Alcaraz M,Perez-Higueras A,et al.Percutaneous vertebroplasty: functional improvement in patients with osteoporotic compression fractures.Spine (Phila Pa 1976). 2006;31(10):1113–1118.

[5] 黄刚,陈海云,刘卓勋,等.经皮椎体成形术与经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折[J].南方医科大学学报,2010, 30(12):2729-2732.

[6] Rousing R,Hansen KL,Andersen MO,et al.Twelve-months follow-up in forty-nine patients with acute/semiacute osteoporotic vertebral fractures treated conservatively or with percutaneous vertebroplasty: a clinical randomized study. Spine (Phila Pa 1976). 2010;35(5):478-482.

[7] Groen RJ, du Toit DF,Phillips FM,et al. Anatomical and pathological considerations in percutaneous vertebroplasty and kyphoplasty: a reappraisal of the vertebral venous system.Spine (Phila Pa 1976).2004;29(13):1465–471.

[8] Deramond H,Wright WT,Belkoff SM.Temperature elevation caused by bone cement polymerization during vertebroplasty. Bone.1999;25(2):17S–24S.

[9] Boger A,Heini P,Windolf M,et al. Adjacent vertebral failure after vertebroplasty: a biomechanical study of low-modulus PMMA cement. Eur Spine J .2007;16(12): 2118-2125.

[10] Turner TM,Urban RM,Singh K,et al.Vertebroplasty comparing injectable calcium phosphate cement compared with polymethylmethacrylate in a unique canine vertebral body large defect model.Spine (Phila Pa 1976).2008;8(3):482-487.

[11] Brown WE,Chow LC.A new calcium setting cement.J Dent Res.1983;63:762-765.

[12] Lim TH,Brebach GT,Renner SM,et al.Biomechanical evaluation of an injectable calcium phosphate cement for vertebroplasty.Spine (Phila Pa 976).2002;27(12):1297-1302.

[13] Smeets R,Kolk A,Gerressen M,et al. A new biphasic osteoinductive calcium composite material with a negative Zeta potential for bone augmentation.Head Face Med. 2009; 5(13): 1-4.

[14] Stein JM,Fickl S,Yekta SS,et al.Clinical evaluation o f a biphasic calcium composite grafting material in the treatment of human periodontal intrabony defects: a 12 month randomized controlled clinical trial. J Periodontol.2009; 80(11): 1774-1782.

[15] 毛海青,邹俊,姜为民,等.新型带负电荷钙磷复合材料促进脊柱融合的实验研究[J].重庆医学,2011,40(7):631-633.

[16] Lill CA,Gerlach UV,Eckhardt C,et al. Bone changes due to glucocorticoid application in an ovariectomized animalmodel for fracture treatment in osteoporosis. Osteoporos Int.2002; 13(5):407-414.

[17] Baofeng L, Zhi Y, Bei C, et al.Characterization of a rabbit osteoporosis model induced by ovariectomy and glucocorticoid. Acta Orthop.2010;81(3):396-401.

[18] 于小巍,王楠,刘凤祥,等.硫酸钙骨水泥修复骨质疏松大鼠骨缺损的研究[J].实用骨科杂志,2009,15(9):678-681.

[19] Pi M,Quarles LD.Osteoblast calcium- sensing receptor has charact-eristics of ANF /7TM receptors.J Cell Biochem. 2005; 95(6):1081-1092.

[20] Bodhak S,Bose S,Bandyopadhyay A.Electrically polarized HAp-coated Ti: in vitro bone cell-material interactions.Acta Biomater.2010;6(2):641-651.

[21] Siemund S,Nilsson LT,Cronqvist M,et al.Initial clinical experience with a new biointegrative cement for vertebroplasty in osteoporotic vertebral fractures.Intern Neuroradiol.2009;15(3):335-340.

[22] 张树芳,江建明,朱青安,等.胸腰椎压缩性骨折模型中genex®骨水泥椎体成形术的生物力学评价[J].南方医科大学学报,2012, 32(6):843-846.