Investigations on bone cement for vertebroplasty

Vertebroplasty is a procedure that introduces bone graft or some biomaterial, typically acrylic cement, into vertebral bodies (VBs) to augment their structural integrity.^1-10 Vertebroplasty was originally performed as an open technique to augment the purchase of pedicle screws for spinal instrumentation11 and to fill voids resulting from tumor resection.^1,3,10,12. Percutaneous vertebroplasty (PVP), the process of injecting acrylic cement into VBs, was reportedly first performed in 1984 to stabilize a C2 vertebra invaded by an aggressive hemangioma.^13. The successful mechanical stabilization of the VB and the resulting pain relief experienced by the patient led investigators to adapt the procedure as a treatment for patients with painful vertebral compression fractures (VCFs) secondary to osteoporosis.^14. Although the procedure is being performed with increasing frequency, many basic questions regarding the efficacy and technical considerations of the procedure have only recently begun to be addressed scientifically. The results of those scientific investigations are summarized in this chapter.