Inexpensive bone cement substitute for vertebral cement augmentation training

Vertebral compression fractures are treated surgically for approximately 25 years. In percutaneous cement augmentation techniques bone cement is applied to a fractured vertebra under fluoroscopic evidence to stabilize the bone fragments. Complications due to leakage of the low viscosity bone cement are reported in 5 to 15% of all routine cases. During the intraoperative application of bone cement surgeons rely on visiohaptic feedback and hence need to be familiar with the cement's rheology properties. Therefore, training is necessary. A hybrid simulator for cement augmentation training was developed but the usage of expensive real cement limits its purpose as a training modality. Twentythree inexpensive bone substitutes were developed and tested with the objective to mimic real bone cement. Cement application measurements were conducted and a mathematical model of the measurement setup was created. Compared with real bone cement, a cement substitute based on Technovit 3040 in combination with radical catchers and additional additives was identified as an appropriate substitute for cement augmentation training.