Resomer C212(C) in vertebroplasty or kyphoplasty: A feasibility study on artificial bones with biomechanical and thermal evaluation

Greiner, Axel; Bongartz, Anne; Woiczinski, Matthias; Befrui, Nima; Pieske, Oliver; Suero, Eduardo M.; Bruder, Jan; Kammerlander, Christian; Böcker, Wolfgang und Becker, Christopher A. (2021): Resomer C212(C) in vertebroplasty or kyphoplasty: A feasibility study on artificial bones with biomechanical and thermal evaluation. In: Technology and Health Care, Bd. 29, Nr. 2: S. 343-350

Abstract

BACKGROUND: Vertebroplasty and kyphoplasty are now well-established methods for treating compression fractures of vertebral bodies (AO type A) as well as vertebral body metastases [1-3]. However, polymethylmethacrylate (PMMA) augmented vertebrae show fractures of subsequent vertebral bodies due to the increased stability of the augmented vertebral body [4]. Resorbable cements are currently only used experimentally. Many commercially available resorbable calcium phosphate cements do not exhibit sufficient biomechanical stability to treat vertebral body fractures [5]. Resomer C212(C) (Evonik Industries AG, Essen, Germany) is a slow resorbable poly--caprolactone that has low melting temperatures and good biomechanical properties. OBJECTIVE: This is a feasibility study on how the poly-epsilon-caprolactone Resomer C212(C) can be used for kypho- or vertebroplasty, what temperatures are used in the argumentation and how differences in load capacity are measurable compared to conventional PMMA cement. METHODS: 23 Sawbones(C) blocks (7.5 Open Cell Foam, SKU: 1522-09, laminated on both sides, 4 x 4 x 2.9 cm, Sawbones, Vashon Island, USA) were divided into three groups: 7 without augmentation, 8 augmented with PMMA cement Traumacem V+(C) (DePuy Synthes, West Chester, USA) and 8 augmented with Resomer C212(C). Temperature measurements were made in a 37 degrees C water bath centrally in the block and on the top and bottom plates. This was followed by a maximum load of up to 2000 N using a universal testing machine (Instron E 10000, Instron Industrial Products, Grove City, USA). RESULTS: In the Resomer C212(C) test group, the maximum average increase in temperature was 4.15 +/- 4.72 degrees C central, 0.3 +/- 0.31 degrees C at the top and 0.78 +/- 1.27 degrees C at the base. In the cement test group, the average increase in temperature was 9.80 +/- 10.65 degrees C centrally in the test block, 1.50 +/- 0.73 degrees C at the top plate and 1.42 +/- 0.66 degrees C and the base plate. In the axial compression test, the 7 non-kyphoplasted test blocks showed a first loading peak on average at 275.23 +/- 80.98 N, a rigidity of 238.47 +/- 71.01 N/mm(2). In the Traumacem V+(C) group, the mean peak load was 313.72 +/- 46.26 N and rigidity was 353.45 +/- 77.23 N/mm(2). The Resomer C212(C) group achieved a peak load of 311.74 +/- 52.05 N and a stiffness of 311.30 +/- 126.63 N/mm(2). A compression to 50% could not be seen in any test block under the load of 2000 N. At 2000 N, Traumacem V+(C)'s average height reduction was 9.26 +/- 2.16 mm and Resomer C212(C) was 10.93 +/- 0.81 mm. CONCLUSIONS: It has been shown that the application of Resomer C212(C) in kyphoplasty or vertebroplasty is well feasible. Thermal analysis showed significantly lower temperatures and shorter temperature application in the Resomer C212(C) group. In the biomechanical load up to 2000 N no significant differences could be observed between the individual groups.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0928-7329
• Sprache: Englisch