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Long‐term reaction to bone cement in osteoporotic bone: new bone formation in vertebral bodies after vertebroplasty
Author(s) -
Braunstein Volker,
Sprecher Christoph M.,
Gisep Armando,
Benneker Lorin,
Yen Kathrin,
Schneider Erich,
Heini Paul,
Milz Stefan
Publication year - 2008
Publication title -
journal of anatomy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.932
H-Index - 118
eISSN - 1469-7580
pISSN - 0021-8782
DOI - 10.1111/j.1469-7580.2008.00883.x
Subject(s) - osteoporosis , bone cement , radiography , medicine , cancellous bone , vertebral compression fracture , bone formation , sagittal plane , cement , dentistry , anatomy , radiology , materials science , pathology , metallurgy
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. The thoracic spine of an 80‐year‐old female was explanted 3.5 years after vertebroplasty with polymethylmethacrylate. The treatment had been performed due to painful osteoporotic compression fractures. Individual vertebral bodies were cut in axial or sagittal sections after embedding. The sections were analysed using contact radiography and staining with toluidine blue. Furthermore, selected samples were evaluated with scanning electron microscopy and micro‐compted tomography (in‐plane resolution 6 µm). Large amounts of newly formed callus surrounding the injected polymethylmethacrylate were detected with all imaging techniques. The callus formation almost completely filled the spaces between the vertebral endplate, the cancellous bone, and the injected polymethylmethacrylate. In trabecular bone microfractures and osteoclast lacuna were bridged or filled with newly formed bone. Nevertheless, the majority of the callus formation was found in the immediate vicinity of the polymethylmethacrylate without any obvious relationship to trabecular fractures. The results indicate for the first time that, contrary to established knowledge, even in osteoporosis the formation of large amounts of new bone is possible.