Tanvir Md Amit Hasan, Khaleque Md Abdul, Kim Ga-Hyun, Park Sang-Eun, Lee Hwan-Hee, Kim Young-Yul
Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea, Seoul 34943, Republic of Korea.
Int J Mol Sci. 2025 May 16;26(10):4786. doi: 10.3390/ijms26104786.
Poly (methyl methacrylate) (PMMA) bone cement is widely used in percutaneous vertebroplasty to stabilize osteoporotic vertebral compression fractures. However, its clinical application is limited by its high compressive modulus, risk of thermal necrosis, and poor bone integration, unlike conventional PMMA formulations used in vertebrae or joint arthroplasty, which can reach polymerization temperatures exceeding 100 °C. Spine-specific PMMA is formulated to cure at a reduced polymerization temperature, thereby minimizing the rise in core temperature during the setting process. Consistent with our hypothesis, this moderate thermal output induces localized thermal injury that triggers osteogenic responses and extracellular matrix production, thereby enhancing osteoblast activity in the surrounding bone. This study aimed to evaluate bone remodeling following spine-specific PMMA injection in an osteoporotic Sprague-Dawley (SD) rat model. Twenty-four osteoporotic female SD rats were randomly assigned to three groups: Control (untreated), OVX + spine-specific PMMA (OVX + PMMA), and OVX (OVX + Defect). Bone regeneration was assessed using dual-energy X-ray absorptiometry (DXA), micro-computed tomography (Micro-CT), quantitative PCR (qPCR), immunohistochemistry (IHC), and Western blotting. At 12 weeks post-injection, the OVX + PMMA group exhibited significantly greater bone regeneration than the OVX group. Micro-CT analysis demonstrated a marked increase in trabecular thickness in the PMMA-treated group. Notably, bone formation was more pronounced in regions surrounding the cement compared to adjacent untreated areas. This suggests that spine-specific PMMA promotes osteogenesis via localized thermal necrosis and subsequent osteoblast recruitment. These findings highlight the dual role of spine-specific PMMA in both structural stabilization and biologically driven bone regeneration. Further research is warranted to optimize its clinical applications while minimizing potential adverse effects.
聚甲基丙烯酸甲酯（PMMA）骨水泥广泛应用于经皮椎体成形术，以稳定骨质疏松性椎体压缩骨折。然而，与用于椎体或关节置换术的传统PMMA配方不同，其临床应用受到高压缩模量、热坏死风险和骨整合性差的限制，传统配方在聚合时温度可超过100°C。脊柱专用PMMA的配方可在降低的聚合温度下固化，从而在凝固过程中将核心温度的升高降至最低。与我们的假设一致，这种适度的热输出会引起局部热损伤，从而触发成骨反应和细胞外基质生成，进而增强周围骨骼中的成骨细胞活性。本研究旨在评估在骨质疏松的Sprague-Dawley（SD）大鼠模型中注射脊柱专用PMMA后的骨重塑情况。24只骨质疏松雌性SD大鼠被随机分为三组：对照组（未治疗）、去卵巢+脊柱专用PMMA组（OVX+PMMA）和去卵巢组（OVX+缺损）。使用双能X线吸收法（DXA）、微计算机断层扫描（Micro-CT）、定量聚合酶链反应（qPCR）、免疫组织化学（IHC）和蛋白质印迹法评估骨再生情况。注射后12周，OVX+PMMA组的骨再生明显高于OVX组。Micro-CT分析显示，PMMA治疗组的小梁厚度显著增加。值得注意的是，与相邻未治疗区域相比，骨水泥周围区域的骨形成更为明显。这表明脊柱专用PMMA通过局部热坏死和随后的成骨细胞募集促进成骨。这些发现突出了脊柱专用PMMA在结构稳定和生物驱动的骨再生中的双重作用。有必要进一步研究以优化其临床应用，同时将潜在的不良反应降至最低。
