Affiliations: Laboratoire de biomécanique, Département de génie mécanique, Université de Sherbrooke, Sherbrooke, QC, Canada J1K 2R1 | Orthopaedic Research Laboratory, McGill University, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, Canada H3A 1A1 | Dr Robert Mathys Foundation, Bischmattstr. 12, CH‐2544 Bettlach, Switzerland | Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, 3010 Bern, Switzerland
Note: [] Corresponding author: Marc Bohner, Dr Robert Mathys Foundation, Bischmattstr. 12, CH‐2544 Bettlach, Switzerland. Tel.: +41 32 644 14 13; Fax: +41 32 6442 11 76; E‐mail: marc.bohner@rms‐foundation.ch.
Abstract: The incidence of osteoporotic bone fractures is growing exponentially as the western population ages and as life expectancy increases. Vertebroplasty, where acrylic or calcium phosphate cement is injected into the weakened vertebrae to augment them, is an emerging procedure for treating spinal fragility fractures. However, cement injection is currently limited because there are no clear standards for a safe, reproducible and predictable procedure. The purpose of this paper is to examine the role that bone cements play in the underlying bio‐mechanisms that affect the outcomes of cement injection. Our most important finding after combining clinical, laboratory and theoretical research is that the process of cement injection poses conflicting demands on bone cements. The cements are required to be more viscous and less viscous at the same time. The challenge therefore is to develop biomaterials, techniques and/or devices that can overcome or manage the conflicting demands on cement viscosity.
Keywords: Vertebroplasty, biomaterials, acrylic and calcium‐phosphate bone cements, injectability, extravasation, injection forces
