Small intestinal submucosa/polymethyl methacrylate composite bone cement for vertebral repair

Abstract

Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) are widely used to treat patients who suffer painful vertebral compression fractures. Both procedures involve the injection of filling materials into the fractured vertebra. In the clinic, the most commonly used bone cement is polymethyl methacrylate (PMMA). However, it has some inherent disadvantages, including poor osteoinductivity and excessive stiffness when used for vertebroplasty. The objective of this study was to develop novel small intestinal submucosa/polymethyl methacrylate (SIS/PMMA) composite bone cement for vertebral repair. The SIS/PMMA composite cement had a porous three-dimensional structure with lower compressive strength and compressive modulus than commercially available PMMA. Both MC3T3-E1 cells and bone marrow mesenchymal stem cells (BMSCs) adhered better to the SIS/PMMA composites than to PMMA. In addition, cell proliferation and osteogenic differentiation of MC3T3-E1 cells were enhanced when cultured on the SIS/PMMA composites. In a vertebral defect model, the SIS/PMMA composites greatly enhanced osteointegration, tissue union, and bone regeneration. In conclusion, this work suggests that the SIS/PMMA composite can be used to treat vertebral compression fracture.