A comprehensive review of deactivation and modification of selective catalytic reaction catalysts installed in cement kilns.

After the ultralow emission transformation of coal-fired power plants, cement production became China's leading industrial emission source of nitrogen oxides. Flue gas dust contents at the outlet of cement kiln preheaters were as high as 80-100 g/m3, and the calcium oxide content in the dust exceeded 60%. Commercial V2O5(-WO3)/TiO2 catalysts suitable for coal-fired flue gas suffer from alkaline earth metal Ca poisoning of cement kiln flue gas. Recent studies have also identified the poisoning of cement kiln selective catalytic reaction (SCR) catalysts by the heavy metals lead and thallium. Investigation of the poisoning process is the primary basis for analyzing the catalytic lifetime. This review summarizes and analyzes the SCR catalytic mechanism and chronicles the research progress concerning this poisoning mechanism. Based on the catalytic and toxification mechanisms, it can be inferred that improving the anti-poisoning performance of a catalyst enhances its acidity, surface redox performance-active catalytic sites, and shell layer protection. The data provide support in guiding engineering practice and reducing operating costs of SCR plants. Finally, future research directions for SCR denitrification catalysts in the cement industry are discussed. This study provides critical support for the development and optimization of poisoning-resistant SCR denitrification catalysts.

Study on Temperature Response of Rubberized Concrete Pavement Based on Fiber Bragg Grating Testing Technology.

The temperature response of pavement is not only crucial for assessing the internal stresses within pavement structures but is also an essential parameter in pavement design. Investigating the temperature response of rubberized concrete pavements (RCP) can support the construction of large-scale rubber concrete pavements. This study constructed a pavement monitoring system based on fiber Bragg grating technology to investigate the temperature distribution, temperature strain, temperature effects, and temperature stress of RCP. The results show that the daily temperature-time history curves of concrete pavement exhibit a significant asymmetry, with the heating phase accounting for only one-third of the curve. The temperature at the middle of RCP is 1.8 °C higher than that of ordinary concrete pavement (OCP). The temperature distribution along the thickness of the pavement follows a "spindle-shaped" pattern, with higher temperatures in the center and lower temperatures at the ends. Additionally, the addition of rubber aggregates increases the temperature strain in the pavements, makes the temperature-strain hysteresis effect more pronounced, and increases the curvature of the pavement slab. However, the daily stress range at the bottom of RCP is approximately 0.7 times that of OCP.

The influence of selected grain size fractions of coal fly ash on properties of clay-cement mortars used for the flood levees construction.

This study examines the influence of different grain size fractions of coal fly ash on the properties of clay-cement mortars used in flood levee construction. Dry aerodynamic separation and mesh sieving were used to obtain ultrafine, fine, and medium fractions of high-calcium and silica fly ash. The experimental results reveal that the rheological properties of fresh mortars are significantly influenced by these fractions. High-calcium fly ash mortars exhibit high reactivity and rapid increase in viscosity, with finer fractions showing the highest reactivity. Silica ashes show increased reactivity in the later stages of suspension hardening. Their spherical shape contributes to reducing internal friction during flow in initial technological operations. Furthermore, the compressive strength of hardened mortars improves as the particle size decreases for both ashes, resulting in a dense and uniform microstructure. The separation and fractionation of fly ashes contribute to the obtaining of fractions that influence the parameters of clay-cement suspension application on different scales. The results show the potential benefits of ash separation, which can bring advantages in terms of economic viability, engineering performance, and ecological sustainability.

Effect of Graphene Oxide Nanoparticles Incorporation on the Mechanical Properties of a Resin-Modified Glass Ionomer Cement.

The objective of this study was to evaluate the effect of incorporating different concentrations of graphene oxide (GO) nanoparticles on the mechanical properties of a resin-modified glass ionomer cement (RMGIC). A commercial RMGIC (Resiglass R, Biodinâmica) was modified by incorporating 0.1% and 0.5% (by weight) of GO into the powder's material. An unmodified RMGIC was used as a control group. Powder samples were characterized using Scanning Electron Microscopy (SEM) and Energy Dispersive Spectroscopy (EDS). Specimens were fabricated and subjected to flexural strength (n = 15), modulus of elasticity (n = 15), Vicker's microhardness (n = 10), and surface roughness tests (n = 10). Data were analyzed using one-way ANOVA and Tukey's post hoc test (α = 5%). Experimental groups' powder demonstrated a homogeneous dispersion of GO. No statistically significant difference was observed in flexural strength (p = 0.067) and modulus of elasticity (p = 0.143) tests. The groups containing 0.1% and 0.5% GO showed significantly higher microhardness and lower surface roughness values (p < 0.001) compared to the control group. The incorporation of GO nanoparticles at concentrations of 0.1% and 0.5% improved the microhardness and surface roughness without negatively affecting the flexural strength and modulus of elasticity of an RMGIC.

The Changes in the Inner-Structure and Mechanical Strength of the Composite Cement Materials and Silica-Carbon Nanotube-Nylon 66 Electrospun Nanofibers.

This study presents the feasibility of improving some selected mechanical strengths and the inner-structural analyses of cement matrix by electrospun nanofibers containing nylon 66, nanosilica, and carbon nanotube. The hybrid electrospun nanofibers were fabricated and mixed into ordinary Portland cement. From the mechanical strength test results, the hybrid nanofibers have shown their role in improving the tensile, compressive, and toughness behavior of the mixed cement material. The improvements of 62%, 38%, and 69%, respectively, were observed compared to those of the control paste. The novelty of the surface and inner structure of the hybrid fibers, as well as the modified cement matrix, were observed by the scanned images from electron microscopes. Besides, the additional pozzolanic reaction between the generated calcium hydroxide and the attached silica was clarified thanks to the results of energy dispersive spectroscopy, X-ray diffraction, and thermal gravimetric analysis. Finally, the consistency between mechanical strength results and inner-structure analyses showed the potential of the proposed fiber to improve cement-based materials.

Mechanical Properties of Latex-Modified Cement Stone under Uniaxial and Triaxial Cyclic Loading.

During the cyclic injection and extraction process in underground storage wellbores, the cement sheath undergoes loading and unloading stress cycles. In this study, we investigated the mechanical properties of latex-modified cement stone (LMCS), widely used in oil and gas wells, through uniaxial and triaxial cyclic loading and unloading tests. The aim of the study was to determine the effect of various loading conditions on the compressive strength and stress-strain behavior of LMCS. The results show that the stress-strain curve of LMCS exhibits a hysteresis loop phenomenon, with the loop intervals decreasing throughout the entire cyclic loading and unloading process. As the number of cycles increases, the cumulative plastic strain of the LMCS increases approximately linearly. Under uniaxial cyclic loading and unloading conditions, the elastic modulus tends to stabilize. However, under triaxial conditions, the elastic modulus increases continuously as the number of cycles increases. This result provides data for engineering predictions. Furthermore, a comparison of the uniaxial and triaxial cyclic loading and unloading of LMCS shows that its cumulative plastic strain develops rapidly under uniaxial conditions, while the elastic modulus is larger under triaxial conditions. These findings provide a valuable reference for constructing underground storage wellbores.

Locking Plate Fixation with Calcium Phosphate Bone Cement Augmentation for Elderly Proximal Humerus Fractures-A Single-Center Experience and Literature Review.

Proximal humerus fractures (PHFs) are among the most common upper-extremity fractures, with a rising incidence linked to the growing elderly population. Treatment options include non-surgical and surgical methods, but the best approach for geriatric PHFs remains debated. Patient selection for treatment must consider clinical and functional outcomes and the potential complications of surgery. Osteoporosis, a key factor in elderly PHFs, meaning those in patients over 65 years old, often results from low-energy trauma and necessitates treatments that enhance bone healing. Bone cement, such as calcium phosphate, is widely used to improve fracture stability and healing. However, the benefits of surgical fixation with bone cement augmentation (BCA) for elderly PHF patients remain controversial. Hence, in this article, we searched databases including MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science to analyze the evidence on locking plate fixation (LPF) with BCA for proximal humeral fractures. We aim to provide readers with updates concerning the above issues.

A Review on Concrete Superplasticizers and Their Potential Applications for Enhancing the Performance of Thermally Activated Recycled Cement.

With the rapid development of the construction industry worldwide, a large amount of waste concrete is generated each year, which has caused serious environmental problems. As a green and sustainable building material, thermally activated recycled cement (RC) has received widespread attention. However, the unique properties of RC, such as the high water demand and short setting time, necessitate the use of specialized superplasticizers that are different from those used in ordinary Portland cement. As an important component for the application of RC, superplasticizer has an important impact on the performance modification of RC. This article summarizes the recent research progress of potential superplasticizers for RC, with a view to providing a reference for the research and application of superplasticizers for RC. Based on the differences between ordinary Portland cement and RC, the paper discusses potential superplasticizers that may be suitable for RC, and points out that future development of potential modified superplasticizers can include altering the molecular structure to improve adsorption onto the surfaces of RC or to enhance the durability of concrete with RC.

Mechanical and Drying Shrinkage Performance Study of Ultra-High-Performance Concrete Prepared from Titanium Slag under Different Curing Conditions.

This research investigates the effects of various curing regimes, the incorporation of titanium slag, and the utilization of quartz sand on the strength properties and shrinkage behavior of ultra-high-performance concrete (UHPC). By using low-heat silicate cement to prepare UHPC, this study conducted standard curing and steam curing, and comprehensively analyzed the macro and micro performance of UHPC under different curing conditions. The findings indicate that the application of steam curing markedly enhances the mechanical attributes of UHPC while efficiently decreasing its drying shrinkage. In the comparative tests, we found that the compressive strength of concrete that had undergone 2 days of steam curing was 9.15% higher than that of concrete cured for 28 days under standard conditions. In addition, under the same curing conditions, titanium slag sand had higher mechanical properties than quartz sand. Under standard curing conditions, the 28-day compressive strength of UHPC using titaniferous slag aggregate was 12.64% higher than that of UHPC using standard sand. Through the data analysis of XRD, TG, and MIP, we found that the content of Ca(OH)2 in the hydration products after steam curing was reduced compared to the standard curing conditions, and the pore structure had been optimized. The UHPC prepared with titanium slag sand has greater advantages in mechanical properties and drying shrinkage, and has a smaller pore structure than the UHPC prepared with quartz sand. Moreover, the use of titanium slag sand offers ecological and economic benefits, making it a more sustainable and cost-effective option for high-performance construction applications.

Effect of Stöber Nano-SiO2 Particles on the Hydration Properties of Calcined Coal Gangue-Blended Cement.

This study focuses on the calcined coal gangue (CCG)-blended cements containing Stöber nano-SiO2 (SNS) particles. The effects of SNS particles on the workability, hydration behaviour, mechanical properties and microstructure evolution of the blended cements were comprehensively investigated at curing ages ranging from 1 to 28 d. The hydration behaviour was studied via isothermal calorimetry test, X-ray diffraction (XRD) and thermogravimetric (TG) tests. The microstructural evolution was studied using mercury intrusion porosimetry (MIP) and scanning electron microscopy (SEM). The results show that the incorporation of SNS led to a significant reduction in fluidity, particularly at an SNS content of 3%. The SNS significantly increased the compressive strength of the CCG-blended cement at all curing ages, and the optimum SNS content was found to be 2%. SNS significantly accelerated not only the early cement hydration but also the pozzolanic reaction of CCG at later curing ages, resulting in a decrease in portlandite, as evidenced by the isothermal calorimetry, XRD and TG analysis. Microstructural analysis shows that the incorporation of SNS effectively refined the pore structure of the CCG-blended cement, resulting in the formation of a dense microstructure. All these beneficial effects of SNS provides advantages in the development of the compressive strength of the CCG-blended cement at all curing ages.

Nanocrystalline Cellulose to Reduce Superplasticizer Demand in 3D Printing of Cementitious Materials.

One challenge for 3D printing is that the mortar must flow easily through the printer nozzle, and after printing, it must develop compressive strength fast and high enough to support the layers on it. This requires an exact and difficult control of the superplasticizer (SP) dosing. Nanocrystalline cellulose (CNC) has gained significant interest as a rheological modifier of mortar by interacting with the various cement components. This research studied the potential of nanocrystalline cellulose (CNC) as a mortar aid for 3D printing and its interactions with SPs. Interactions of a CNC and SP with cement suspensions were investigated by means of monitoring the effect on cement dispersion (by monitoring the particle chord length distributions in real time) and their impact on mortar mechanical properties. Although cement dispersion was increased by both CNC and SP, only CNC prevented cement agglomeration when shearing was reduced. Furthermore, combining SP and CNC led to faster development of compressive strength and increased compressive strength up to 30% compared to mortar that had undergone a one-day curing process.

Investigation on Cement-Stabilized Base with Recycled Aggregate and Desert Sand.

This paper mainly explores the feasibility of using desert sand (DS) and recycled aggregate in cement-stabilized bases. Recycled coarse aggregate (RCA) and DS serve as the substitutes of natural coarse and fine aggregates, respectively, in cement-stabilized bases. A four-factor and four-level orthogonal test is designed to analyze the unconfined compressive strength, splitting tensile strength, and compressive resilient modulus. Furthermore, this paper investigates the effects of cement content, fly ash (FA) replacement rate, RCA replacement rate, and DS replacement rate on the road performance of cement-stabilized bases composed of RCA and DS. The test results reveal that the performance of cement-stabilized bases with partial RCA instead of natural coarse aggregate (NCA) and partial DS instead of natural fine aggregate satisfies the road use. The correlation and microscopic analyses of the test results imply the feasibility of applying DS and recycled aggregate to cement-stabilized bases. This paper calculates and evaluates the life cycle of carbon emissions of desert sand and recycled coarse aggregate cement-stabilized macadam (DRCSM) and finds that both DS and RCA can reduce the carbon emissions of CSM, which has a positive effect on improving the environment and solving the climate crisis. It is hoped that this paper can offer a solid theoretical foundation for promoting the application of DS and recycled aggregate in road engineering.

The Application of Converter Sludge and Slag to Produce Ecological Cement Mortars.

The paper presents an analysis of the effective use of a mixture of steel sludge (S1) and slag (S2) from the converter process of steel production for the production of cement mortars. Metallurgical waste used in the research, which is currently deposited in waste landfills and heaps near plants, posing a threat to groundwater (possibility of leaching metal ions present in the waste), was used as a substitute for natural sand in the range of 0-20% by weight of cement (each). The obtained test results and their numerical analysis made it possible to determine the conditions for replacing part of the sand in cement mortars with a mixture of sludge and slag from a basic oxygen furnace (BOF) and to determine the effects of such modification. For the numerical analysis, a full quadratic Response Surface Model (RSM) was utilized for two controlled factors. This model was subsequently optimized through backward stepwise regression, ensuring the inclusion of only statistically significant components and verifying the consistency of residual distribution with the normal distribution (tested via Ryan-Joiner's test, p > 0.1). The designated material models are helpful in designing ecological cement mortars using difficult-to-recycle waste (i.e., sludge and converter slag), which is important for a circular economy. Mortars modified with a mixture of metallurgical waste (up to 20% each) are characterized by a slightly lower consistency, compressive and flexural strength, and water absorption. However, they show a lower decrease in mechanical strength after the freezing-thawing process (frost resistance) compared to control mortars. Mortars modified with metallurgical waste do not have a negative impact on the environment in terms of leaching heavy metal ions. The use of a mixture of sludge and steel slag in the amount of 40% (slag/sludge in a 20/20 ratio) allows you to save 200 kg of sand when producing 1 m3 of cement mortar (cost reduction by approx. EUR 5.1/Mg) and will also reduce the costs of the environmental fee for depositing waste.

Development of Sustainable Construction Materials from Inert Waste Mixtures Using the Mechanosynthesis Process.

This research investigates the potential of mechanosynthesis to transform inert waste mixtures into sustainable construction materials. Three waste streams were employed: recycled glass, recycled concrete, and excavated soils. Two alternative material formulations, F1 (50% recycled concrete, 30% recycled glass, 20% excavated soil) and F2 (60% excavated soil, 20% recycled concrete, 20% recycled glass), were developed. Cement pastes were produced by partially substituting cement (CEM I) with 50% of either F1 or F2. Characterization techniques, including X-ray diffraction (XRD), Fourier transform infrared spectroscopy (ATR-FTIR), and mechanical testing, were performed. Cement pastes incorporating milled waste materials exhibited significantly enhanced compressive strength compared to their unmilled counterparts. At 28 curing days, compressive strengths reached 44, 47, 45, and 49.7 MPa, and at 90 curing days, they increased to 47.5, 50, 55, and 61 MPa for milling conditions of 200 rpm for 5 min, 200 rpm for 15 min, 400 rpm for 5 min, and 400 rpm for 15 min, respectively. In addition, F1 formulations showed higher compressive strengths than the reference CEM II and CEM III pastes. These results highlight the efficacy of mechanosynthesis in valorizing construction waste, mitigating CO2 emissions, and creating environmentally friendly construction materials.

Geothermal Nano-SiO2 Waste as a Supplementary Cementitious Material for Concrete Exposed at High Critical Temperatures.

The partial replacement effect of Portland cement by geothermal nano-SiO2 waste (GNSW) for sustainable Portland-cement-based concrete was investigated to improve the properties of concrete exposed at high critical temperatures. Portland cement was partially replaced by 20 and 30 wt.% of GNSW. The partial replacement effect on Portland-cement-based concrete subjected to 350, 550, and 750 °C was evaluated by measuring the weight changes, ultrasonic pulse velocity, thermogravimetric and differential thermal analysis, X-ray diffraction, surface inspection, and scanning electron microscopy under residual conditions. The ultrasonic pulse velocity results showed that the GNSW specimens maintained suitable stability after being heated to 350 °C. The SEM analysis revealed a denser microstructure for the 20 wt.% of partial replacement of Portland cement by GNSW specimen compared to the reference concrete when exposed to temperatures up to 400 °C, maintaining stability in its microstructure. The weight losses were higher for the specimens with partial replacements of GNSW than the reference concrete at 550 °C, which can be attributed to the pozzolanic activity presented by the GNSW, which increases the amounts of CSH gel, leading to a much denser cementitious matrix, causing a higher weight loss compared to the reference concrete. GNSW is a viable supplementary cementitious material, enhancing thermal properties up to 400 °C due to its high pozzolanic activity and filler effect while offering environmental benefits by reducing industrial waste.

Development of a Superhydrophobic Protection Mechanism and Coating Materials for Cement Concrete Surfaces.

In order to further enhance the erosion resistance of cement concrete pavement materials, this study constructed an apparent rough hydrophobic structure layer by spraying a micro-nano substrate coating on the surface layer of the cement concrete pavement. This was followed by a secondary spray of a hydroxy-silicone oil-modified epoxy resin and a low surface energy-modified substance paste, which combine to form a superhydrophobic coating. The hydrophobic mechanism of the coating was then analysed. Firstly, the effects of different types and ratios of micro-nano substrates on the apparent morphology and hydrophobic performance of the rough structure layer were explored through contact angle testing and scanning electron microscopy (SEM). Subsequently, Fourier transform infrared spectroscopy and permeation gel chromatography were employed to ascertain the optimal modification ratio, temperature, and reaction mechanism of hydroxy-silicone oil with E51 type epoxy resin. Additionally, the mechanical properties of the modified epoxy resin-low surface energy-modified substance paste were evaluated through tensile tests. Finally, the erosion resistance of the superhydrophobic coating was tested under a range of conditions, including acidic, alkaline, de-icer, UV ageing, freeze-thaw cycles and wet wheel wear. The results demonstrate that relying solely on the rough structure of the concrete surface makes it challenging to achieve superhydrophobic performance. A rough structure layer constructed with diamond micropowder and hydrophobic nano-silica is less prone to cracking and can form more "air chamber" structures on the surface, with better wear resistance and hydrophobic performance. The ring-opening reaction products that occur during the preparation of modified epoxy resin will severely affect its mechanical strength after curing. Controlling the reaction temperature and reactant ratio can effectively push the modification reaction of epoxy resin through dehydration condensation, which produces more grafted polymer. It is noteworthy that the grafted polymer content is positively correlated with the hydrophobicity of the modified epoxy resin. The superhydrophobic coating exhibited enhanced erosion resistance (based on hydrochloric acid), UV ageing resistance, abrasion resistance, and freeze-thaw damage resistance to de-icers by 19.41%, 18.36%, 43.17% and 87.47%, respectively, in comparison to the conventional silane-based surface treatment.

Shrinkage and Creep Properties of Low-Carbon Hybrid Cement.

Hybrid cements combine clinker with large amount of supplementary cementitious materials while utilizing hydration and alkali activation processes. This paper summarizes shrinkage and creep properties of industrially produced H-cement, containing only 20% of Portland clinker. In comparison with a reference cement CEM II/B-S 32.5 R, autogenous shrinkage is smaller after 7 days, and drying shrinkage is similar at similar times. A different capillary system of H-cement leads to faster water mass loss during drying. Basic and total creep of concrete remains in the standard deviation of B4 and EC2 creep models. The results demonstrate that shrinkage and creep properties of concrete made from H-cement have similar behavior as conventional structural concrete or high-volume fly ash concrete.

New Discovery of Natural Zeolite-Rich Tuff on the Northern Margin of the Los Frailes Caldera: A Study to Determine Its Performance as a Supplementary Cementitious Material.

The release of Neogene volcanism in the southeastern part of the Iberian Peninsula produced a series of volcanic structures in the form of stratovolcanoes and calderas; however, other materials also accumulated such as large amounts of pyroclastic materials such as cinerites, ashes, and lapilli, which were later altered to form deposits of zeolites and bentonites. This work has focused on an area located on the northern flank of the San José-Los Escullos zeolite deposit, the only one of its kind with industrial capacity in Spain. The main objective of this research is to characterize the zeolite (SZ) of this new area from the mineral, chemical, and technical points of view and establish its possible use as a natural pozzolan. In the first stage, a study of the mineralogical and chemical composition of the selected samples was carried out using X-ray diffraction (XRD), scanning electron microscopy (SEM), X-ray fluorescence (XRF), and thermogravimetric analysis (TGA); in the second stage, chemical-qualitative and pozzolanicity technical tests were carried out at 8 and 15 days. In addition, a chemical analysis was performed using XRF on the specimens of mortars made with a standardized mixture of Portland cement (PC: 75%) and natural zeolite (SZ: 25%) at the ages of 7, 28, and 90 days. The results of the mineralogical analyses indicated that the samples are made up mainly of mordenite and subordinately by smectite, plagioclase, quartz, halloysite, illite, and muscovite. Qualitative chemical assays indicated a high percentage of reactive silica and reactive CaO and also negligible contents of insoluble residues. The results of the pozzolanicity test indicate that all the samples analyzed behave like natural pozzolans of good quality, increasing their pozzolanic reactivity from 8 to 15 days of testing. Chemical analyses of PC/SZ composite mortar specimens showed how a significant part of SiO2 and Al2O3 are released by zeolite while it absorbs a large part of the SO3 contained in the cement. The results presented in this research could be of great practical and scientific importance as they indicate the continuation of zeolitic mineralization beyond the limits of the San José-Los Escullos deposit, which would result in an increase in geological reserves and the extension of the useful life of the deposit, which is of vital importance to the local mining industry.

Toxicological Effects of Leachates Extracted from Photocatalytic Concrete Blocks with Nano-TiO2 on Daphnia magna.

The incorporation of titanium dioxide nanoparticles into concrete blocks for paving adds photocatalytic functionality to the cementitious matrix, providing self-cleaning and pollutant-degrading properties. However, wear and leaching from these pavements can release potentially toxic compounds into water bodies, affecting aquatic organisms. In this context, this study evaluated the toxicological effects of leachates from photocatalytic concrete containing nano-TiO2 with an average size of 10 nm and anatase crystallinity on Daphnia magna. Acute and chronic toxicity tests on neonates were conducted with two leachate extracts: one from reference concrete and one from photocatalytic concrete (with 9% nano-TiO2 added by mass of cement). In terms of acute toxicity, the reference concrete extract had an EC50 of 104.0 mL/L at 48 h, whereas the concrete with TiO2 had an EC50 of 64.6 mL/L at 48 h. For chronic toxicity, the leachate from reference concrete had a significant effect (p < 0.05) on the size parameter with an LOEC of 4 mL/L, whereas the leachate from concrete with 9% nano-TiO2 did not have significant toxicological effects on any of the analyzed parameters (longevity, size, reproduction, and age of first posture) (LOEC > 6.5 mL/L). Furthermore, FTIR analysis indicated that TiO2 nanoparticles were not detected in the leachates, suggesting efficient anchoring within the cementitious matrix. The results indicate that there was no increase in the chronic toxicity of the leachate from the cementitious matrix when nanoparticles were added at a 9% mass ratio of cement.

Perfecting the pour: A novel co-axial technique with sequential injections for optimising cement delivery during sacroplasty.

BACKGROUND: Percutaneous sacroplasty is an effective treatment for painful sacral fractures and tumours, however there is no accepted optimal technique for performing this procedure. This study investigated a novel approach to sacroplasty combining co-axial sacral access, sequential cement injections and hypothermic cement manipulation to improve cement delivery. METHODS: This retrospective study analysed 11 patients who underwent co-axial sacroplasty between April 2023 and March 2024 for treatment of painful insufficiency fractures (n = 5) or malignant sacral tumours (n = 6). All cases were performed using biplane fluoroscopy with conebeam CT navigation for planning and monitoring percutaneous access. Procedural details, technical outcomes, and clinical outcomes including Numerical Rating Scale (NRS) pain and analgesic utilisation on a six-point scale were analysed pre-procedure and at follow-up. RESULTS: Technical success of was achieved in all cases using this technique. The mean injected cement volume was 20.5 ± 6.4 ml. Median pre-procedural NRS pain scores of 8 (IQR 7.25-8) significantly decreased to 0 (IQR, 0-0.25) at follow-up (p <.01). The median preprocedural analgesic utilisation score reduced from 3 (IQR, 2-3) to 0 (IQR, 0-2.5) at follow-up (p <.01). Cement leakage occurred during two cases without associated adverse clinical sequelae. There were no major adverse events. CONCLUSION: Co-axial sequential injection sacroplasty is a safe and effective technique which allows facilitates controlled delivery of cement. Improved control of cement delivery, including around high-risk structures for cement leakage, offers a potential safety advantage over conventional sacroplasty techniques. Further research comparing technical and clinical outcomes to conventional techniques is warranted.