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A Signal-Inducing Bone Cement for Magnetic Resonance Imaging-Guided Spinal Surgery Based on Hydroxyapatite and Polymethylmethacrylate

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Abstract

The aim of this study was to develop a signal-inducing bone cement for magnetic resonance imaging (MRI)–guided cementoplasty of the spine. This MRI cement would allow precise and controlled injection of cement into pathologic lesions of the bone. We mixed conventional polymethylmethacrylate bone cement (PMMA; 5 ml methylmethacrylate and 12 g polymethylmethacrylate) with hydroxyapatite (HA) bone substitute (2–4 ml) and a gadolinium-based contrast agent (CA; 0–60 μl). The contrast-to-noise ratio (CNR) of different CA doses was measured in an open 1.0-Tesla scanner for fast T1W Turbo-Spin-Echo (TSE) and T1W TSE pulse sequences to determine the highest signal. We simulated MRI-guided cementoplasty in cadaveric spines. Compressive strength of the cements was tested. The highest CNR was (1) 87.3 (SD 2.9) in fast T1W TSE for cements with 4 μl CA/ml HA (4 ml) and (2) 60.8 (SD 2.4) in T1W TSE for cements with 1 μl CA/ml HA (4 ml). MRI-guided cementoplasty in cadaveric spine was feasible. Compressive strength decreased with increasing amounts of HA from 46.7 MPa (2 ml HA) to 28.0 MPa (4 ml HA). An MRI-compatible cement based on PMMA, HA, and CA is feasible and clearly visible on MRI images. MRI-guided spinal cementoplasty using this cement would permit direct visualization of the cement, the pathologic process, and the anatomical surroundings.

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Acknowledgments

This project was financed by TSB Technologiestiftung Berlin–Zukunftsfonds Berlin and cofinanced by the European Union–European Fund for Regional Development (Project No. 10132816/10134231). The mechanical tests were performed at aap Biomaterials, Dieburg, Germany. We thank Christoph Sattig and Nora Lämmel from aap Biomaterials for their valuable contributions.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Center for Musculoskeletal Surgery, University Charité, 13353, Berlin, Germany

    Florian Wichlas, Christian J. Seebauer, Rene Schilling, Sascha S. Chopra & Hermann J. Bail

  2. Department of Radiology, University Charité, 13353, Berlin, Germany

    Jens Rump, Thula Walter & Ulf K. M. Teichgräber

Authors
  1. Florian Wichlas
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  2. Christian J. Seebauer
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  3. Rene Schilling
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  4. Jens Rump
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  5. Sascha S. Chopra
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  6. Thula Walter
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  7. Ulf K. M. Teichgräber
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  8. Hermann J. Bail
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Correspondence to Florian Wichlas.

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Wichlas, F., Seebauer, C.J., Schilling, R. et al. A Signal-Inducing Bone Cement for Magnetic Resonance Imaging-Guided Spinal Surgery Based on Hydroxyapatite and Polymethylmethacrylate. Cardiovasc Intervent Radiol 35, 661–667 (2012). https://doi.org/10.1007/s00270-011-0192-0

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  • DOI: https://doi.org/10.1007/s00270-011-0192-0

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