Journal List > J Korean Orthop Assoc > v.54(5) > 1136194

Jin-Hyeok, Young-Ha, Ju-Seon, Do-Hun, Ok-Gul, Sang-Wook, and Chan-Ho: Characteristics of Blood Mixed Cement in Percutaneous Vertebroplasty

Abstract

Purpose:

This study evaluated the efficacy of blood mixed cement for osteoporotic vertebral compression fractures in reducing the complications of percutaneous vertebroplasty using conventional cement.

Materials and Methods:

This study was performed retrospectively in 80 patients, from January 2016 to January 2017. Porous cement was formed by mixing 2, 4, and 6 ml of blood with 20 g of cement used previously. A tube with a diameter and length of 2.8 mm and 215 mm, respectively, was used and the polymerization temperature, setting time, and optimal passing-time were measured and compared with those using only conventional cement. Radiologically, the results were evaluated and compared.

Results:

The polymerization temperature was 70.3°C, 55.3°C, 52.7°C, and 45.5°C in the conventional cement (R), 2 ml (B2), 4 ml (B4), and 6 ml (B6), respectively, and the corresponding setting time decreased from 960 seconds (R) to 558 seconds (B2), 533 seconds (B4), and 500 seconds (B6). The optimal passing-time was 45 seconds (B2), 60 seconds (B4), and 78 seconds (B6) at 73 seconds (R), respectively and as the amount of blood increased, it was similar to the cement passing-time. The radiological results showed that the height restoration rates and the vertebral subsidence rates similar among the groups. Two cases of adjacent vertebral compression fractures in the R group and one in the B2 and B4 groups were encountered, and the leakage rate of the cement was approximately two times higher than that in the conventional cement group.

Conclusion:

In conventional percutaneous vertebroplasty, the procedure of using autologous blood with cement decreased the polymerization temperature, reduced the setting time, and the incidence of cement leakage was low. These properties may contribute to more favorable mechanical properties that can reduce the complications compared to conventional cements alone.

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Figure 1.
Percutaneous vertebroplasty. (A) Needle injection into vertebral body. (B) After cement injection into the vertebra.
jkoa-54-435f1.tif
Table 1.
Comparison of Blood Mixed Cement with Conventional Cement according to Blood Volume
Variable R B2 B4 B6 p-value
Sex (male/female) 6/14 3/17 5/15 4/16
Age (yr) 70.6±6.5 69.6±7.2 73.2±6.8 70.4±7.9 0.102
Bone density (T-score) -3.1±0.8 -3.0±1.1 -3.2±0.8 -3.1±1.0 0.323
Polymerization temperature (°C) 70.3±2.1 55.3±1.6 52.7±2.1 45.5±0.9 0.045
Corresponding setting time (s) 960±12 558±10 533±8 500±5 0.038
Optimal passing-time (s) 73±3.1 45±2.5 60±3.3 78±1.2 0.012
Height restoration rate (%) 5.0±6.3 5.2±5.6 6.0±7.2 5.8±5.1 0.721
Vertebral subsidence rate (%) 6.0±8.3 5.2±7.8 5.5±6.6 4.8±7.0 0.633
Adjacent vertebral compression fracture (cases) 2 1 1 0 0.783

Values are presented as number only or mean±standard deviation. R, conventional cement only; B2, 2 ml blood mixed cement; B4, 4 ml blood mixed cement; B6, 6 ml blood mixed cement.

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