Calcium phosphate cements for bone augmentation through vertebroplasty

Lead Research Organisation: University of Leeds
Department Name: Mechanical Engineering

Abstract

Traditional procedures to stabilise the spine following fracture involve highly invasive surgery to attach instrumentation, in many cases via two separate approaches, to the posterior and/or anterior of the spine. High risks are associated with this procedure because the patient has often suffered multiple injuries and the surgery is in close proximity to the spinal cord and major blood vessels. Recently, a new technique called 'vertebroplasty' has been investigated as an alternative treatment for spinal burst fractures, which are caused by high energy impacts. Using this procedure, bone cement is injected into the fractured vertebra to stabilise the segment without the need for major invasive surgery. Although this technique shows potential, the cements used have yet to be optimised for the treatment of burst fractures. Since this type of injury most commonly occurs in younger patients, there is potential for bony regrowth following the fracture. Therefore, it is proposed that materials that support bone growth, such as calcium phosphate (CaP), will provide a better means of fixation. The aim of this study is to investigate and optimise the use of CaP cements for the primary fixation of burst fractures. The study will combine the expertise in cement development and biological evaluation at Queen's University Belfast with that in spinal modelling at the University of Leeds.The project will involve determining the optimum properties for the cements across a range of patients using computational techniques. These properties will be realised through novel material formulation and processing. The long term success of the cements will then be assessed using in vivo and in vitro testing.

Publications

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Zhao Y (2010) Modelling cement augmentation: a comparative experimental and finite element study at the continuum level. in Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine

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O'Hara RM (2010) Optimisation of the mechanical and handling properties of an injectable calcium phosphate cement. in Journal of materials science. Materials in medicine

 
Description A new computer modelling technique was developed and validated against experimental tests to simulate the mechanical
behaviour of spinal vertebrae after fracture. The model was used to evaluate the 'vertebroplasty' technique where cement is injected into damaged bone to stabilise the fracture. It was found that the surgical technique (i.e. the volume of cement injected) was more critical than the properties of the cements, suggesting that the flow properties of the cement are more important than their final stiffness upon setting.
Exploitation Route The experimental and computational methods developed can be applied to evaluate a range of materials for vertebroplasty and used by industry as part of pre-clinical testing and optimisation processes. The methods also have applications as research tools to investigate other clinical interventions such as subchondroplasty in the knee.
Sectors Healthcare

 
Description Methodologies were developed to evaluate the vertebroplasty procedure which are now being adopted by industry. These methods have the potential to enable improved materials to be developed an tested prior to clinical use.
First Year Of Impact 2016
Sector Healthcare
Impact Types Economic

 
Description British Orthopaedic Association Latta Fellowship
Amount £400,000 (GBP)
Funding ID GRA/01/10/01 
Organisation British Orthopaedic Association 
Sector Academic/University
Country United Kingdom
Start 04/2009 
End 09/2014
 
Description EPSRC Challenging Engineering
Amount £1,062,951 (GBP)
Funding ID EP/F010575/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 05/2008 
End 04/2013
 
Description ERC Starting grant
Amount € 1,500,000 (EUR)
Organisation European Research Council (ERC) 
Sector Public
Country Belgium
Start 12/2012 
End 11/2017
 
Description ULTRASPINE: Ultrasound-Enabled Minimally Invasive Disc Replacement
Amount £991,843 (GBP)
Funding ID EP/K020757/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 04/2013 
End 03/2018
 
Description Local engagement activities 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? Yes
Geographic Reach Local
Primary Audience Schools
Results and Impact Stands always very popular with large numbers of delegates attending and requests to hold follow-on activities with schools and exhibit at future events.

Extremely positive feedback from attendees, teachers and parents, leading to increasing requests to provide exhibits for other events
Year(s) Of Engagement Activity 2009,2010,2011,2012,2013,2014