Assessing cement injection behaviour in cancellous bone: An in vitro study using flow models. (October 2014)

• Record Type: Journal Article
• Authors: Bou-Francis, Antony; López, Alejandro; Persson, Cecilia; Hall, Richard M; Kapur, Nikil
• Is Part Of: Journal of biomaterials applications. Volume 29:Number 4(2014:Nov.)
• Page Start: 582
• Page End: 594
• Publication Date: 2014-10
• Subjects: Bone cement -- bone surrogates -- cement flow behaviour -- vertebral augmentation -- cement leakage; Biomedical engineering -- Periodicals; Biomedical materials -- Periodicals; 610.28
• DOI: 10.1177/0885328214537858
• Languages: English
• ISSNs: 0885-3282

Abstract

Understanding the cement injection behaviour during vertebroplasty and accurately predicting the cement placement within the vertebral body is extremely challenging. As there is no standardized methodology, we propose a novel method using reproducible and pathologically representative flow models to study the influence of cement properties on injection behaviour. The models, confined between an upper glass window and a lower aluminium plate, were filled with bone marrow substitute and then injected (4, 6 and 8 min after cement mixing) with commercially available bone cements (SimplexP, Opacity+, OsteopalV and Parallax) at a constant flow rate (3 mL/min). A load cell was used to measure the force applied on the syringe plunger and calculate the peak pressure. A camera was used to monitor the cement flow during injection and calculate the following parameters when the cement had reached the boundary of the models: the time to reach the boundary, the filled area and the roundness. The peak pressure was comparable to that reported during clinical vertebroplasty and showed a similar increase with injection time. The study highlighted the influence of cement formulations and model structure on the injection behaviour and showed that cements with similar composition/particle size had similar flow behaviour, while the introduction of defects reduced the time to reach the boundary, the filled area and the roundness. The proposed method provides a novel tool for quick, robust differentiation between various cement formulations through the visualization and quantitative analysis of the cement spreading at various time intervals.