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Percutaneous Vertebral Osteoinduction in Osteoporosis and Tumors 2008

Interventional Spine

Luigi Manfrè, MD
Delfo Matarazzo, MD, Non ASSR Member
Vincenzo Rampulla, MD, Non ASSR Member
Gabriele Corsale, MD, Non ASSR Member
Letizia Tomarchio, MD, Non ASSR Member
Concetto Cristaudo, PhD, Non ASSR Member

Scientific Paper

Purpose

With the aim of replacing the conventional PMMA cement, several injectable new polymers have been tested. We tested a new water suspension of osteoinductive bioceramic, easily injectable through conventional vertebroplastic needles, in osteoporotic and neoplastic patients. To authors knowledge, no other similar procedure has been performed before.

Methods & Materials

From February 2005, 15 patients (8 osteoporotic and 7 neoplastic) underwent CT-guided percutaneous injection of a 57% water suspension of nanometrich granuli of magnesium-added hydroxyapathite bioceramic (SINTlife® - Finceramica - Faenza, IT). In 14 cases we treated lumbar and/or thoracic vertebral bone. In one patient, the sacrum was treated. The patients underwent pre- and post-op CT and MR controls.

Results

After a period of 30 to 45 days, the injected vertebra / sacrum developed dense sclerotic bone regrowing, resembling the original bone shape, without extraosseous abnormality.

Conclusion

Although a study on a larger population has to be performed evaluating the possibility to use new bioceramic for treating non-fractured VB at-risk for future fracture, Mg-HA could be an interesting new tool to adopt in severe osteoporotic disease, when significant risk for specific residual non fractured VB at risk for fracture exists. In neoplastic patients, regrowth of the bone can be the solution for large osteolitic areas.

References

1. Mathis JM, Barr JD, Belkoff SM, Barr MS, Jensen ME, Deramond H. Percutaneous vertebroplasty: a developing standard of care for vertebral compression fractures. AJNR Am J Neuroradiol 2001;22: 373-38
2. Kim SB, Kim YJ, Yoon TL, Park SA, Cho IH, Kim EJ. The characteristics of a hydroxyapatite-chitosan-PMMA bone cement. Biomaterials. 2004 Nov;25(26):5715-23.
3. Kawanabe K, Tamura J, Yamamuro T, Nakamura T, Kokubo T, Yoshihara S. A new bioactive bone cement consisting of bisGMA resin and bioactive glass powder. J Appl Biomater 1993; 4:135-141.