Review of New Bone Substitute for Vetebral Fractures

In this report doctors review new filler materials used for bone fractures of the spine. Vertebrae of the spine weakened by osteoporosis or cancer can break called vertebral compression fractures. Cement can be used to repair the fracture or fill in the bone.

But there are some problems with the current filler cements. They can't remodel or reform the bone. High heat is needed to inject the cement. The heat may damage the blood vessels in the bone. And while the cement is stiff and that's needed for the fracture, sometimes it's too stiff and doesn't allow motion where it's needed.

Scientists are trying to make new materials that can be absorbed by the bone and help form new bone. These synthetic bone substitutes have been tested in animals such as dogs and sheep. None are ready for use in the human spine yet. Some just cost too much. Others are absorbed quickly but take too long to set up.

The authors report two other important features of bone fillers. They must be seen on X-rays to help guide the surgeon during the operation. The cement must flow through a small needle to inject it into the vertebral body. The cement can't act too quickly or the needle can get stuck in the bone.

From the review of all studies the conclusion is that the current cement called polymethylmethacrylate (PMMR) really works the best. Better filler materials may be ready in the future. They must be affordable and have better features than the PMMR.

Isador H. Lieberman, MD, MBA, FRCS(C), et al. Vertebroplasty and Kyphoplasty: Filler Materials. In The Spine Journal. November/December 2005. Vol. 5. No. 6S. Pp. 305S-316S.

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