Cement augmentation by using polymethylmethacrylate (PMMA) is a commonly used treatment for patients with osteoporotic vertebral fractures. However, adjacent level fracture after surgery due to the mismatched mechanical properties between PMMA and the osteoporotic cancellous bone is a concern. Indeed, the stiffness of PMMA bone cement is about seven to ten times higher as compared with that of osteoporotic vertebral cancellous bone. Furthermore, tissue necrosis after operation has been reported, since its polymerization is chemically exothermic, thereby potentially damaging the surrounding tissues.
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