Histopathologic findings of retrieved specimens of vertebroplasty with polymethylmethacrylate cement: case control study.
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.
Huang
Kuo-Yuan
KY
Department of Orthopedics, Institute of Clinical Medicine, National Cheng Kung University Medical Center, Taiwan.
Yan
Jing-Jou
JJ
Lin
Ruey-Mo
RM
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
D001843:Bone Cements; D019904:Polymethyl Methacrylate