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Evaluation of an Injectable Biphasic Calcium Sulfate/Hydroxyapatite Cement for the Augmentation of Fenestrated Pedicle Screws in Osteoporotic Vertebrae : A Biomechanical Cadaver Study

Tian, Xinggui LU ; Raina, Deepak B. LU ; Vater, Corina ; Kilian, David ; Ahlfeld, Tilman ; Platzek, Ivan ; Nimtschke, Ute ; Tägil, Magnus LU ; Lidgren, Lars LU and Thomas, Alexander , et al. (2022) In Journal of Functional Biomaterials 13(4).
Abstract

Cement augmentation of pedicle screws is one of the most promising approaches to enhance the anchoring of screws in the osteoporotic spine. To date, there is no ideal cement for pedicle screw augmentation. The purpose of this study was to investigate whether an injectable, bioactive, and degradable calcium sulfate/hydroxyapatite (CaS/HA) cement could increase the maximum pull-out force of pedicle screws in osteoporotic vertebrae. Herein, 17 osteoporotic thoracic and lumbar vertebrae were obtained from a single fresh-frozen human cadaver and instrumented with fenestrated pedicle screws. The right screw in each vertebra was augmented with CaS/HA cement and the un-augmented left side served as a paired control. The cement distribution,... (More)

Cement augmentation of pedicle screws is one of the most promising approaches to enhance the anchoring of screws in the osteoporotic spine. To date, there is no ideal cement for pedicle screw augmentation. The purpose of this study was to investigate whether an injectable, bioactive, and degradable calcium sulfate/hydroxyapatite (CaS/HA) cement could increase the maximum pull-out force of pedicle screws in osteoporotic vertebrae. Herein, 17 osteoporotic thoracic and lumbar vertebrae were obtained from a single fresh-frozen human cadaver and instrumented with fenestrated pedicle screws. The right screw in each vertebra was augmented with CaS/HA cement and the un-augmented left side served as a paired control. The cement distribution, interdigitation ability, and cement leakage were evaluated using radiographs. Furthermore, pull-out testing was used to evaluate the immediate mechanical effect of CaS/HA augmentation on the pedicle screws. The CaS/HA cement presented good distribution and interdigitation ability without leakage into the spinal canal. Augmentation significantly enhanced the maximum pull-out force of the pedicle screw in which the augmented side was 39.0% higher than the pedicle-screw-alone side. Therefore, the novel biodegradable biphasic CaS/HA cement could be a promising material for pedicle screw augmentation in the osteoporotic spine.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
biomaterial, biomechanical, calcium sulfate/hydroxyapatite, cement, osteoporosis, pedicle screw augmentation
in
Journal of Functional Biomaterials
volume
13
issue
4
article number
269
publisher
MDPI AG
external identifiers
  • pmid:36547529
  • scopus:85144868306
ISSN
2079-4983
DOI
10.3390/jfb13040269
language
English
LU publication?
yes
id
7bbcb344-46fe-43d5-9f9b-0456c3f31edf
date added to LUP
2023-01-05 11:36:03
date last changed
2024-04-18 17:39:05
@article{7bbcb344-46fe-43d5-9f9b-0456c3f31edf,
  abstract     = {{<p>Cement augmentation of pedicle screws is one of the most promising approaches to enhance the anchoring of screws in the osteoporotic spine. To date, there is no ideal cement for pedicle screw augmentation. The purpose of this study was to investigate whether an injectable, bioactive, and degradable calcium sulfate/hydroxyapatite (CaS/HA) cement could increase the maximum pull-out force of pedicle screws in osteoporotic vertebrae. Herein, 17 osteoporotic thoracic and lumbar vertebrae were obtained from a single fresh-frozen human cadaver and instrumented with fenestrated pedicle screws. The right screw in each vertebra was augmented with CaS/HA cement and the un-augmented left side served as a paired control. The cement distribution, interdigitation ability, and cement leakage were evaluated using radiographs. Furthermore, pull-out testing was used to evaluate the immediate mechanical effect of CaS/HA augmentation on the pedicle screws. The CaS/HA cement presented good distribution and interdigitation ability without leakage into the spinal canal. Augmentation significantly enhanced the maximum pull-out force of the pedicle screw in which the augmented side was 39.0% higher than the pedicle-screw-alone side. Therefore, the novel biodegradable biphasic CaS/HA cement could be a promising material for pedicle screw augmentation in the osteoporotic spine.</p>}},
  author       = {{Tian, Xinggui and Raina, Deepak B. and Vater, Corina and Kilian, David and Ahlfeld, Tilman and Platzek, Ivan and Nimtschke, Ute and Tägil, Magnus and Lidgren, Lars and Thomas, Alexander and Platz, Uwe and Schaser, Klaus Dieter and Disch, Alexander C. and Zwingenberger, Stefan}},
  issn         = {{2079-4983}},
  keywords     = {{biomaterial; biomechanical; calcium sulfate/hydroxyapatite; cement; osteoporosis; pedicle screw augmentation}},
  language     = {{eng}},
  number       = {{4}},
  publisher    = {{MDPI AG}},
  series       = {{Journal of Functional Biomaterials}},
  title        = {{Evaluation of an Injectable Biphasic Calcium Sulfate/Hydroxyapatite Cement for the Augmentation of Fenestrated Pedicle Screws in Osteoporotic Vertebrae : A Biomechanical Cadaver Study}},
  url          = {{http://dx.doi.org/10.3390/jfb13040269}},
  doi          = {{10.3390/jfb13040269}},
  volume       = {{13}},
  year         = {{2022}},
}