Biomechanical efficacy of prophylactic vertebroplasty with respect to initial bone mineral density

Percutaneous vertebroplasty is a potential intervention for the prophylactic reinforcement of human vertebral bodies to reduce the growing prevalence of age-related osteoporotic vertebral fractures. The goal of this study was to determine the minimum amount of bone cement needed to provide the mechanical enhancement beyond a fracture risk level. Also, minimizing the injected bone cement volume may reduce complications that are due to leakage of the bone cement into the surrounding tissue. Our findings indicated that biomechanical efficacy of prophylactic vertebroplasty did strongly depend on the initial bone density. Therefore, for low bone densities, only a fraction of the bone cement volume is needed to provide the same amount of stiffness increase compared to vertebral bodies with higher bone densities. We also conclude that bipedicular placement of maximum 20% fill of bone cement is sufficient to reduce vertebral bodies fracture risk from a high to minimum risk.