Percutaneous vertebroplasty: a new animal model.

BACKGROUND CONTEXT: Percutaneous vertebroplasty (PVP) is a minimally invasive surgical procedure and is frequently performed in humans who need surgical treatment of vertebral fractures. PVP involves cement injection into the vertebral body, thereby providing rapid and significant pain relief. PURPOSE: The testing of novel biomaterials depends on suitable animal models. The aim of this study was to develop a reproducible and safe model of PVP in sheep. STUDY DESIGN: This study used ex vivo and in vivo large animal model study (Merino sheep). METHODS: Ex vivo vertebroplasty was performed through a bilateral modified parapedicular access in 24 ovine lumbar hemivertebrae, divided into four groups (n=6). Cerament (Bone Support, Lund, Sweden) was the control material. In the experimental group, a novel composite was tested-Spine-Ghost-which consisted of an alpha-calcium sulfate matrix enriched with micrometric particles of mesoporous bioactive glass. All vertebrae were assessed by micro-computed tomography (micro-CT) and underwent mechanical testing. For the in vivo study, 16 sheep were randomly allocated into control and experimental groups (n=8), and underwent PVP using the same bone cements. All vertebrae were assessed postmortem by micro-CT, histology, and reverse transcription-polymerase chain reaction (rt-PCR). This work has been supported by the European Commission under the 7th Framework Programme for collaborative projects (600,000-650,000 USD). RESULTS: In the ex vivo model, the average defect volume was 1,275.46±219.29 mm3. Adequate defect filling with cement was observed. No mechanical failure was observed under loads which were higher than physiological. In the in vivo study, cardiorespiratory distress was observed in two animals, and one sheep presented mild neurologic deficits in the hind limbs before recovering. CONCLUSIONS: The model of PVP is considered suitable for preclinical in vivo studies, mimicking clinical application. All sheep recovered and completed a 6-month implantation period. There was no evidence of cement leakage into the vertebral foramen in the postmortem examination.

Template-assisted electrohydrodynamic atomization of polycaprolactone for orthopedic patterning applications.

This paper presents the development of the novel deposition of biodegradable polycaprolactone (PCL) polymer patterns on a metallic substrate using a jet spraying technique, template-assisted electrohydrodynamic atomization (TAEA), at ambient temperature. The structure of patterns was controlled by systematically varying the polymer concentration (2-15 wt.%) and the flow rate (1-25 µl min(-1)). Polymer deposition was carried out in the stable cone-jet mode to precisely control the surface structure and morphology. The patterns were studied by optical microscopy, scanning electron microscopy and profilometry, and a high degree of control over the pattern geometry and thickness was achieved by varying the spraying time. The hardness and the effective elastic modulus of the polymer patterns were estimated using nanoindentation. The effect of load, loading rate and the holding time on the hardness and effective elastic modulus was derived. Optimal results were obtained with 5 wt.% PCL in DMAC solution sprayed within the stable cone-jet mode operating window at a flow rate of 15 µl min(-1) for 300 s at 11.1 kV with a working distance of 60mm. Hexagonal patterns were well-defined and repeatable with thickness of ~34 µm. The hardness is 1.6 MPa at a loading rate of 0.1 µN/s and nearly halved when the load rate was increased to 1 µN/s. The effective elastic modulus of ~12 MPa is obtained for a load rate of 0.1 µN/s.

The use of preserved tissue in finite element modelling of fresh ovine vertebral behaviour.

The aim of this study was to investigate whether the predicted finite element (FE) stiffness of vertebral bone is altered when using images of preserved rather than fresh tissue to generate specimen-specific FE models. Fresh ovine vertebrae were used to represent embalmed (n = 3) and macerated dry-bone (n = 3) specimens and treated accordingly. Specimens were scanned pre- and post-treatment using micro-computed tomography. A constant threshold level derived from these images was used to calculate the respective bone volume fraction (BV/TV) from which the conversion factor validated for fresh tissue was used to determine material properties that were assigned to corresponding FE models. Results showed a definite change in the BV/TV between the fresh and the preserved bone. However, the changes in the predicted FE stiffness were not generally greater than the variations expected from assignment of loading and boundary conditions. In conclusion, images of preserved tissue can be used to generate FE models that are representative of fresh tissue with a tolerable level of error.