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Percutaneous Vertebral Osteoinduction in non-fractured vertebra: time for prophylaxis? 2007

Interventional Spine

Luigi Manfré, MD
Concetto Cristaudo, MD, Non ASSR Member
Gabriele Corsale, MD, Non ASSR Member
Delfo Matarazzo, MD, Non ASSR Member
Enzo Rampulla, MD, Non ASSR Member
Letizia Tomarchio, MD, Non ASSR Member

Scientific Paper

Purpose

Despite Percutaneous Vertebroplasty excellent results, the high rate of additional vertebral fractures (VCF) within one year remains one of the main problem in the management of osteopenic patients. We tested a new injectable osteoinductive bioceramic (Mg-HA) in 5 non-fractured vertebra bones, in the aim to activate focal osteogenesis into non-fractured cancellous vertebral bone (Percutaneous Osteoinduction). To the author's knowledge, no study has yet been reported on this issue in humans.

Methods & Materials

During Vertebroplasty treatments for osteoporotic fractures in 3 patients, 3 to 5cc of of a 57% water suspension of nanometrich granuli of magnesium-added hydroxyapathite bioceramic was injected into 5 non-fractured vertebral body considered at risk for future fracture, according the American Association for Osteoporotic Disease. Patients remained in our Istitution for 48h, and were finally discharged at day 2 totally painless.

Results

CT and MRI studies follow-up at day 1, 15, 30 and 60 after the injection of bioceramic material were performed. Initial sclerosis at day 30 and massive sclerosis at day 60 of the non-fractured vertebra injected with osteoinductive bioceramic was appreciated. No complication related to the procedure and/or bioceramic was appreciated. The patients remain painless

Conclusion

Magnesium-added bioceramics are able to stimulare bone re-growth in human bone. Although a study on a larger population is needed, bioceramic Mg-HA could be an interesting new tool to adopt in severe osteoporotic patients, when significant risk for residual non fractured VB at risk for fracture exists.

References

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2. Kayanja MM, Ferrara LA, Lieberman IH. Distribution of anterior cortical shear strain after a thoracic wedge compression fracture. Spine J 2004;4.
3. 50. Fabbri M., Celotti G.C., Ravaglioli A.: Hydroxyapatite-based porous aggregates: physico-chemical nature, structure, texture and architecture. Biomaterials 1995; 15 : 312-5