title: Histopathologic findings of retrieved specimens of vertebroplasty with polymethylmethacrylate cement: case control study.
abstract: METHODS
  Case control study.
  
  
  OBJECTIVE
  To investigate the histopathologic findings of 2 retrieved specimens from failed vertebroplasty with polymethylmethacrylate (PMMA) cement.
  
  
  BACKGROUND
  Vertebroplasty using PMMA cement has been commonly used to treat debilitating back pain from compression fracture, angiomas, and metastatic cancer. However, there was concern about the unpredictable future results with PMMA cement. The histopathologic changes were rarely reported.
  
  
  METHODS
  There were 2 PMMA augmented and 3 nonaugmented fractured vertebral bodies retrieved for histopathologic study. Between the 2 groups, we compared the findings of bone necrosis, foreign body reaction, fibrotic wall formation, and neovascularization.
  
  
  RESULTS
  Bone necrosis was noted in the periphery of PMMA cement, which was surrounded by fibrotic tissues. In contrast, no fibrotic wall formation could be found in the nonaugmented control group. Foreign body reaction was only noted in PMMA augmented cases, and neovascularization was only noted in the control cases.
  
  
  CONCLUSIONS
  PMMA cement might not be as bioinert as we considered. Therefore, the long-term safety of vertebroplasty should be further evaluated.
authors.affiliation: Department of Orthopedics, Institute of Clinical Medicine, National Cheng Kung University Medical Center, Taiwan.
authors.forename: Kuo-Yuan
authors.initials: KY
authors.lastname: Huang
authors.forename: Jing-Jou
authors.initials: JJ
authors.lastname: Yan
authors.forename: Ruey-Mo
authors.initials: RM
authors.lastname: Lin
mesh_terms: D000368:Aged; D001178:Arthroplasty; D001843:Bone Cements / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D005355:Fibrosis; D005549:Foreign-Body Reaction / Q000139:chemically induced; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009389:Neovascularization, Pathologic / Q000139:chemically induced; D019904:Polymethyl Methacrylate / Q000009:adverse effects* / Q000627:therapeutic use; D012086:Reoperation; D016103:Spinal Fractures / Q000473:pathology* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000473:pathology; D017211:Treatment Failure
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate