New, Andrew M.
Finite element modelling of thermal damage to tissue by curing bone cement in vertebroplasty
In Proceedings of the 2003 Summer Bioengineering Conference.
American Society Of Mechanical Engineers (ASME)., .
Vertebroplasty is a surgical technique in which a collapsed or
collapsing vertebra is injected with bone cement in order to stabilize
the vertebra and/or prevent further collapse. Vertebral collapse most
commonly occurs in osteoporotic vertebral bodies and may lead to loss
of height or other spinal deformity, pain and occasionally neurological
complications. The principal aim of the vertebroplasty procedure is
pain relief, although an alternative technique which also uses bone
cement, kyphoplasty, also aims to reverse deformity. The main
advantages of vertebroplasty are that it can be carried out by injection
of the cement into the vertebra through the skin, which is less
traumatic for the patient than alternative treatments which may involve
open surgery, and that it can be performed as an outpatient procedure
which results in low cost. Early reports suggest that the technique is
successful, most studies reporting pain relief in 67-100% of patients,
although length of follow-up is currently relatively short .
Although the cement clearly plays a structural role, the effects of
the cement curing process are not fully understood. It has been
proposed that heat generation during cement polymerization may
destroy pain receptors within the vertebral body, contributing to the
pain relieving effect of the procedure. On the other hand, some
surgeons have expressed concern that excessive heat generation may
lead to damage to the spinal cord or nerve roots as they exit the
The aims of this study, therefore, were to implement a finite
element (FE) model of the cement curing process and to use the model
to assess temperature histories of tissue surrounding a bolus of cement
curing within a vertebral body.
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