Modified poly(methyl methacrylate) bone cement in the treatment of Kümmell disease

Jinjin Zhu; Shuhui Yang; Yute Yang; Teng Yao; Gang Liu; Shunwu Fan; He Zhao; Fuzhai Cui; Xiumei Wang; Guoqiang Jiang; Xiangqian Fang

doi:10.1093/rb/rbaa051

Modified poly(methyl methacrylate) bone cement in the treatment of Kümmell disease

Regen Biomater. 2021 Jan 9;8(1):rbaa051. doi: 10.1093/rb/rbaa051. eCollection 2021 Feb 1.

Authors

Jinjin Zhu^{1

2}, Shuhui Yang³, Yute Yang^{1

2}, Teng Yao^{1

2}, Gang Liu^{1

2}, Shunwu Fan^{1

2}, He Zhao⁴, Fuzhai Cui³, Xiumei Wang³, Guoqiang Jiang⁵, Xiangqian Fang^{1

2}

Affiliations

¹ Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
² Key Laboratory of Musculoskeletal System Degeneration and Regeneration Translational Research of Zhejiang Province, Hangzhou 310016, China.
³ State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China.
⁴ Department of Orthopedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China.
⁵ Department of Spinal Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, China.

Abstract

Kümmell disease (KD) causes serious vertebral body collapse in patients. However, only a few case reports have been conducted and the number of patients with KD investigated was limited. Additionally, the frequently used poly(methyl methacrylate) (PMMA) bone cement for KD is limited by excessive modulus and poor biocompatibility. Herein, we aimed to modify PMMA bone cement with mineralized collagen (MC), and compare the clinical effects, image performance and finite element analysis between the modified bone cement and PMMA bone cement for the treatment of phase I and II KD. Thirty-nine KD patients treated with PMMA bone cement and 40 KD patients treated with MC-modified PMMA bone cement from June 2015 to March 2017 were retrospectively analyzed. The surgical procedure, intraoperative blood loss, hospital stay and complications were compared between different groups. Visual analog scale, Oswestry disability index, anterior vertebral height, posterior vertebral height, computed tomography value, adjacent vertebral re-fracture, Cobb angle and wedge-shaped correction angle were evaluated. Additionally, the representative sample was selected for finite element analysis. We found that the MC-modified PMMA bone cement could achieve the same effect as that of PMMA bone cement and was associated with better vertebral height restoration in the long term.

Keywords: Kümmell disease; mechanical property; mineralized collagen; poly(methyl methacrylate) bone cement.