Preparation of novel absorbable bone cement and its biomechanical evaluation in vertebroplasty for calf vertebral compression fractures
Luan wei1, Chen Jiahan1, Teng Yong2, Wurikaixi Aiyiti3, Jiang Houfeng3, Wang Xiaofeng4, Yin Dongfeng4
1Graduate Department of Xinjiang Medical University,Urumqi 830000, China; 2General Hospital of Xinjiang Military Command,Urumqi 830000, China; 3School of Mechanical Engineering, Xinjiang University, Urumqi 830017, China; 4General Hospital of Xinjiang Military Command Pharmacy Department, Urumqi 830000, China
Abstract：Objective To explore poly propylene fumarate (PPF) /β-tricalcium phosphate (β-TCP) absorbable bone cement and study biomechanical properties in vertebroplasty for calf vertebral compression fractures. Methods PPF was prepared by a two-step method, and its number and weight average molecular weight were measured by gel permeation chromatography. Structural analysis of PPF was performed using MR hydrogen spectroscopy. Four kinds of PPF/β-TCP absorbable bone cement formulas formulated based on the mass ratios of 10∶1, 5∶1, 3∶1, and 2∶1 were prepared by thermal crosslinking. Bone cement with high compressive strength and compression modulus was selected for subsequent experiments. Four healthy 2-3-year-old calves were selected, and from their lumbar vertebrae L1 to L4, 16 vertebral bodies were isolated. In addition, the lamina depressions of each vertebral body were filled with dentate powder, and then measured the stress area of each vertebral body. Ten vertebrae with similar forced areas were randomly divided into PPF/β-TCP and PMMA groups according to the number table method with five vertebrae in each group. The vertebral bodies of the PMMA group and PPF/β-TCP group were used to prepare compression fracture models using the MTS-858 mechanical machine. The vertebral height, compressive strength, and stiffness of the two groups were compared when the models were prepared. The PPF/β-TCP group and PMMA group were treated with PPF/β-TCP bone cement and standard PMMA bone cement, respectively, for vertebroplasty of the compression fracture model. The amount of bone cement injection, postoperative vertebral height, vertebral recovery percentage, vertebral compressive strength, and stiffness were compared between the two groups. Results The average molecular weight of PPF was 1 637±55, meanwhile, the average molecular weight of PMMA was 1 741±68, and the polymerization distribution index was 1.06. MR structure analysis indicated that the reaction product was PPF. The compressive strength of formula 1-4 PPF/β-TCP absorbable bone cement was (53.5±1.5), (63.12±0.4), (97.9±5.5), and (100.8±3.2) MPa, respectively, and the compression modulus was (0.97±0.04), (1.05±0.05), (1.10±0.10) and (0.45±0.18) GPa, respectively. Formula 3 with high compressive modulus and compressive strength was selected for vertebroplasty. There were no significant differences found in the vertebral body volume, height, and stressed area between the PPF/β-TCP group and PMMA group (all P values >0.05). There were also no significant differences found in the vertebral height after compression, after vertebroplasty, or recovery percentage between the PPF/β-TCP group and PMMA group (all P values >0.05). Intra-group comparison: In the PPF/β-TCP group, the vertebral compressive strength was (2 282±341) N and (1 848±219) N before and after vertebroplasty, respectively. In addition, the vertebral stiffness was (215±27) N/mm and (182±15) N/mm before and after vertebroplasty, respectively, with no statistical significance (t=2.14, 2.13, all P values >0.05). The compressive strength of the PMMA group was (2 350±289) N and (3 105±452) N before and after vertebroplasty, respectively. Moreover, the vertebral stiffness was (221±26) N/mm and (296±37) N/mm before and after vertebroplasty, respectively, with statistically significant differences (t=2.81, 3.21, all P values <0.05). Comparison between groups: there was no significant difference found in intraoperative bone cement injection between the PPF/β-TCP group and PMMA group (P>0.05). There were no statistically significant differences in preoperative compressive strength and stiffness between the PPF/β-TCP group and the PMMA group (all P values >0.05). However, the postoperative compressive strength and stiffness of the PMMA group were greater than those of the PPF/β-TCP group (t=4.99, 5.61, all P values <0.05). Conclusion The absorbable bone cement prepared by PPF and β-TCP based on the ratio of 3∶1 has the characteristics of mechanical properties similar to the physical properties of human vertebrae and low cross-linking temperature. In the treatment of vertebral compression fractures, PPF/β-TCP absorbable bone cement, and PMMA bone cement have similar intraoperative injection volumes and can achieve the same effect of restoring vertebral height. In addition, the physical properties of vertebrae are better than PMMA cement, which can potentially replace PMMA bone cement in the treatment of vertebral compression fractures.
栾伟, 陈家瀚, 滕勇, 乌日开西·艾依提, 蒋厚峰, 王晓锋, 尹东锋. 新型可吸收骨水泥的制备及其应用于小牛椎体标本压缩性骨折椎体成形术的生物力学研究[J]. 中华解剖与临床杂志, 2022, 27(10): 721-728.
Luan wei, Chen Jiahan, Teng Yong, Wurikaixi Aiyiti, Jiang Houfeng, Wang Xiaofeng, Yin Dongfeng. Preparation of novel absorbable bone cement and its biomechanical evaluation in vertebroplasty for calf vertebral compression fractures. Chinese Journal of Anatomy and Clinics, 2022, 27(10): 721-728.
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2022, Vol. 27 
