• Kuo-Yuan Huang, Jing-Jou Yan, and Ruey-Mo Lin.
• Department of Orthopedics, Institute of Clinical Medicine, National Cheng Kung University Medical Center, Taiwan.
• Spine. 2005 Oct 1; 30 (19): E585-8.

Study DesignCase control study.ObjectiveTo investigate the histopathologic findings of 2 retrieved specimens from failed vertebroplasty with polymethylmethacrylate (PMMA) cement.Summary Of Background DataVertebroplasty using PMMA cement has been commonly used to treat debilitating back pain from compression fracture, angiomas, and metastatic cancer. However, there was concern about the unpredictable future results with PMMA cement. The histopathologic changes were rarely reported.MethodsThere were 2 PMMA augmented and 3 nonaugmented fractured vertebral bodies retrieved for histopathologic study. Between the 2 groups, we compared the findings of bone necrosis, foreign body reaction, fibrotic wall formation, and neovascularization.ResultsBone necrosis was noted in the periphery of PMMA cement, which was surrounded by fibrotic tissues. In contrast, no fibrotic wall formation could be found in the nonaugmented control group. Foreign body reaction was only noted in PMMA augmented cases, and neovascularization was only noted in the control cases.ConclusionPMMA cement might not be as bioinert as we considered. Therefore, the long-term safety of vertebroplasty should be further evaluated.

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