Osteointegration and Resorption of Intravertebral and Extravertebral Calcium Phosphate Cement.
Eleven patients with painful osteoporotic vertebral fractures who underwent kyphoplasty using calcium phosphate (CaP) cement were followed up for 1 week, 1, 2, and 3 years in a monocentric, nonrandomized, noncontrolled retrospective trial.



This study investigates long-term radiomorphologic features of intraosseous CaP cement implants and of extraosseous CaP cement leakages for up to 3 years after implantation by kyphoplasty.



Kyphoplasty is frequently used for the treatment of painful osteoporotic fractures. Of the materials available, CaP is frequently used as a filling material. Resorption of this material is frequently observed, although clinical outcome is comparable with other cements.



Kyphoplasty utilizing CaP cement was performed in 11 patients with painful osteoporotic vertebral fractures. All patients received a pharmacological antiosteoporosis treatment consisting of calcium, vitamin D, and a standard dose of oral bisphosphonates. Radiomorphologic measurements, pain, and mobility were assessed.



Intraosseous and extraosseous CaP cement volumes decreased significantly over 3 years. However, vertebral stability as determined by a constant vertebral body height and the sagittal index was not impaired. Pain improved significantly 2 years after implantation and the mobility scores 1 year after kyphoplasty at least until the third year.



Intravertebral CaP cement implants are resorbed slowly over time without jeopardizing stability and clinical outcomes most likely because of a slowly progressing osseous replacement. Extraosseous CaP cement material because of leakages during the kyphoplasty procedure is almost completely resorbed as early as 2 years after the leakage occurred. Therefore, CaP cement is an important alternative to PMMA-based cement materials utilized for kyphoplasty of osteoporotic vertebral fractures.
Departments of *Medicine I and Clinical Chemistry †Radiology, University of Heidelberg, Heidelberg ‡Institute of Medical Statistics and Biometry, Medical Faculty Mannheim, University of Heidelberg, Mannheim §Surgical Clinic, Division of Traumatology and Reconstructive Surgery, University of Heidelberg, Heidelberg, Germany.
Roman
R
Klein
Ralf
R
Tetzlaff
Christel
C
Weiss
Meike-Kristina
MK
Schäfer
Michael
M
Tanner
Bernd
B
Wiedenhöfer
Ingo
I
Grafe
Peter-Jürgen
PJ
Meeder
Gerd
G
Noeldge
Peter P
PP
Nawroth
Christian
C
Kasperk
D000328:Adult; D000368:Aged; D001835:Body Weight; D001843:Bone Cements / Q000627:therapeutic use*; D002130:Calcium Phosphates / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009068:Movement; D010024:Osteoporosis; D058866:Osteoporotic Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010146:Pain / Q000209:etiology / Q000601:surgery; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome; D064232:Visual Analog Scale
D001843:Bone Cements; D002130:Calcium Phosphates