A simplified method of opacifying and mixing acrylic cement for percutaneous vertebroplasty: a clinical and in vitro study

Cardiovasc Intervent Radiol. 2005 Sep-Oct;28(5):570-7. doi: 10.1007/s00270-004-0126-1.

Abstract

The objective of this study was to simplify the opacifying mixing process of the bone cement and contrast used for percutaneous vertebroplasty (PVP). We performed a biomechanical study of polymethyl methacrylate (PMMA) (Corinplast 3) using three different mixtures of PMMA, monomer, and contrast: group I, 2:1; group II, 3:2; group III, 3:2:1 ratio of powder/monomer/iodinated contrast (Omnipaque). In vitro biomechanical testing of ultimate compressive strength was carried out in all samples. Following the conclusion of a proper bone cement mixture regimen drawn from the in vitro study, PVP was performed in 125 patients: 58 with cancer, 12 with hemangioma, and 54 with osteoporotic fracture. The ultimate compressive strength in group III was decreased by 38% compared to groups II and I. Proper fluoroscopic visualization was achieved in all PVP procedures using this mixture. There were no major complications associated with injection of the cement mixture. Complete (CR) and partial response (PR) was obtained in 64% and 32.8%, respectively. No further vertebral collapse occurred during follow-up. The regimen using iodinated contrast for cement visualization during PVP provides a simple and convenient new method for mixing. Although the biomechanical strength is altered by the contrast medium added, it seems insignificant in clinical practice based on the authors' limited experience.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Cements / therapeutic use*
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery
  • Female
  • Follow-Up Studies
  • Hemangioma / diagnostic imaging
  • Hemangioma / surgery
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods*
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / surgery
  • Pain, Postoperative / etiology
  • Polymethyl Methacrylate / therapeutic use*
  • Spinal Diseases / diagnostic imaging*
  • Spinal Diseases / surgery*
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / surgery
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / surgery
  • Spine / diagnostic imaging*
  • Spine / surgery*
  • Survival Analysis
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / surgery
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Bone Cements
  • Polymethyl Methacrylate