7.12 Injectable bone cements for spinal column augmentation: Materials for kyphoplasty/vertebroplasty

In contemporary surgical practice, injectable bone cements are increasingly being used to treat a variety of pathological conditions of the spine including osteoporotic vertebral compression fractures, metastatic vertebral body lesions and traumatic fractures. The principal goal of applying these injectable bone cements is to augment impaired bony structures in order to maintain or improve the strength and stability of the spinal column. The clinical results obtained in the last decades by using polymethyl methacrylate bone cement in vertebroplasty and balloon kyphoplasty procedures have clearly established a demand for biomaterials better adapted to their function as vertebral body bone void filler. Currently, many new injectable bone cements are being designed specifically for application in the vertebral body. This chapter aims to provide the reader with a brief introduction on the history of injectable bone cements for spinal column augmentation and will discuss its currently accepted indications. The clinical implications of cement leakage will be discussed together with guidelines for bone cement handling to prevent this complication. A quick glance at possible future directions in the field of injectable bone cements for spinal column augmentation will conclude this chapter.