Cardiovascular changes after PMMA vertebroplasty in sheep: the effect of bone marrow removal using pulsed jet-lavage.

Clinically, the displacement of intravertebral fat into the circulation during vertebroplasty is reported to lead to problems in elderly patients and can represent a serious complication, especially when multiple levels have to be treated. An in vitro study has shown the feasibility of removing intravertebral fat by pulsed jet-lavage prior to vertebroplasty, potentially reducing the embolization of bone marrow fat from the vertebral bodies and alleviating the cardiovascular changes elicited by pulmonary fat embolism. In this in vivo study, percutaneous vertebroplasty using polymethylmethacrylate (PMMA) was performed in three lumbar vertebrae of 11 sheep.

The effect of pulsed jet lavage in vertebroplasty on injection forces of PMMA bone cement: an animal study.

Percutaneous vertebroplasty, comprising of the injection of polymethylmethacrylate (PMMA) into vertebral bodies, is an efficient procedure to stabilize osteoporotic compression fractures as well as other weakening lesions. Besides fat embolism, cement leakage is considered to be one of the major and most severe complications during percutaneous vertebroplasty. The viscosity of the PMMA during injection plays a key role in this context.

Temperature evaluation during PMMA screw augmentation in osteoporotic bone--an in vitro study about the risk of thermal necrosis in human femoral heads.

The use of polymethylmethacrylate (PMMA) bone cement to augment hip screws reduces cut-out risk but is associated with an exothermic reaction. This in vitro investigation evaluated the risk of thermal necrosis when augmenting the implant purchase with PMMA. A pilot study analyzed the effects of different PMMA layer thicknesses on temperatures around an implant.

Injection biomechanics of in vitro simulated vertebroplasty - correlation of injection force and cement viscosity.

Cement leakage is considered to be one of the major and most severe complications during percutaneous vertebroplasty. The viscosity of the material plays a key role in this context. At high cement viscosity, the risk of leakage is reduced; however, injection forces are highly increased, rendering injection difficult or even impossible.

The effect of pulsed jet lavage in vertebroplasty on injection forces of polymethylmethacrylate bone cement, material distribution, and potential fat embolism: a cadaver study.

Study Design: In vitro testing of vertebroplasty techniques including pulsed jet-lavage for fat and marrow removal in human cadaveric lumbar and thoracic vertebrae.

Objective: To develop jet-lavage techniques for vertebroplasty and investigate their effect on cement distribution, injection forces, and fat embolism.

Summary Of Background Data: The main complications of cement vertebroplasty are cement leakage and pulmonary fat embolism, which can have fatal consequences and are difficult to prevent reliably by current vertebroplasty techniques.

Injectable bone cement augmentation for the treatment of distal radius fractures: a review.

Fractures of the distal radius often occur as a result of low-energy trauma and are frequently seen in osteoporotic patients. Many biomechanical studies and clinical case series have been carried out to investigate the effects on the fractured bones of different fixation methods such as cast immobilization, percutaneous pins, external fixators, or open reduction with internal fixation. In addition, the use of different bone cements as stand-alone solutions or as an adjunct to the aforementioned fixation methods is described as one possible way of increasing the performance of the fixation by reducing secondary dislocation of the fragments and allowing more intensive rehabilitation of the patients.

Long-term reaction to bone cement in osteoporotic bone: new bone formation in vertebral bodies after vertebroplasty.

Elderly patients frequently suffer from osteoporotic vertebral fractures resulting in the need of vertebroplasty or kyphoplasty. Nevertheless, no data are available about the long-term consequences of cement injection into osteoporotic bone. Therefore, the aim of the present study was to evaluate the long-term tissue reaction on bone cement injected to osteoporotic bone during vertebroplasty.