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Mineralized Collagen Modified Polymethyl Methacrylate Bone Cement for Osteoporotic Compression Vertebral Fracture at 1-Year Follow-up

Zhu, Jinjin, MD; Zhang, Kai, MD; Luo, Kefeng, MD; Qiu, Zhiye, PhD†,‡; Yang, Shuhui; Cui, Fuzhai, PhD; Weng, Xisheng, MD, PhD§; Jiang, Guoqiang, MD

doi: 10.1097/BRS.0000000000002971

Study Design. Retrospective comparative study.

Objective. This study aimed to compare the clinical effects and imaging features of polymethyl methacrylate (PMMA) bone cement with and without mineralized collagen (MC) in percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs).

Summary of Background Data. PKP with PMMA is widely performed for OVCF. However, numerous complications have also been reported about the PMMA bone cement. Moreover, PMMA bone cement with and without MC have not been compared with respect to their postoperative efficacy and long-term follow-up.

Methods. From July 2016 to July 2017, 105 OVCF patients were randomly divided into two groups based on their PKP treatment: MC-PMMA group and PMMA group. Clinical operation, cement leakage, Oswestry Disability Index, visual analog scale, height of the fractured vertebrae, Cobb angle, refracture of the adjacent vertebra, recompression, and computed tomography values of the injured vertebra were compared between the two groups postoperatively and after 1-year follow-up.

Results. Clinical operation showed no differences between the two groups. Visual analog scale scores, Oswestry Disability Index scores, and Cobb angles showed statistically significant differences between the two groups after 1-year follow-up. The height of the vertebral body showed significant difference at 3 days postoperatively and preoperatively in each group and significant difference after 1 year between the two groups. The rate of refracture and leakage of the MC-PMMA group was lower than that of the PMMA group. The computed tomography value of the MC-PMMA group was obviously higher than that of the PMMA group after 1-year follow-up.

Conclusion. MC-modified PMMA did not change the beneficial properties of PMMA. This new bone cement has better biocompatibility, can form a stable structure in the vertebral body, and improve the prognosis of patients by reducing pain and reoperation.

Level of Evidence: 3

This study compared the clinical effects of polymethyl methacrylate with and without mineralized collagen for percutaneous kyphoplasty on 105 patients at 1-year follow-up. The effects of the two bone cements were almost the same at 3 days postoperatively, and the mineralized collagen-polymethyl methacrylate had better effectiveness at 1-year follow-up.

Department of Spinal Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China

School of Materials Science and Engineering, Tsinghua University, Beijing, China

Beijing Allgens Medical Science and Technology Co., Ltd., Beijing, China

§Department of Orthopedics, Peking Union Medical College Hospital, Beijing, China.

Address correspondence and reprint requests to Guoqiang Jiang, MD, Department of Spinal Surgery, The Affiliated Hospital of Medical School of Ningbo University, 247 Renmin Road, Ningbo 315020, Zhejiang, China; E-mail:; Xisheng Weng, MD, PhD, Department of Orthopedics, Peking Union Medical College Hospital, Beijing 100730, China; E-mail:

Received 20 June, 2018

Revised 8 November, 2018

Accepted 19 November, 2018

JZ and KZ contributed equally to this work.

The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

Natural Science Foundation of Zhejiang Province (LY17H060001), Ningbo Natural Science Foundation (A610225), and Beijing Science and Technology Plan (Z171100000417024) were received in support of this work.

No relevant financial activities outside the submitted work.

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