Final Report Summary - SPINEGO (Re-integration of a skilled researcher through an intra-European collaboration on pathology-specific bone cements)
Vertebroplasty is a minimally invasive procedure where bone cement is injected into a fractured vertebra in order to relieve pain and stabilize the fracture. Albeit being a generally successful procedure, new fractures may occur after treatment. These may be due to the natural progression of the underlying disease, e.g. osteoporosis, but a larger amount of new fractures have been found in the immediate vicinity of the treated vertebra, suggesting that the treatment itself may affect the occurrence of new fractures. The high stiffness of the bone cement used, poly(methyl methacrylate) (PMMA), has been suggested to be a reason for a change in the local biomechanics and hence cause a higher amount of new fractures.
The main aim of this project was to investigate the biomechanical potential of pathology-specific bone cements for vertebral fractures, through the development and evaluation of cements with a lower stiffness. This has recently been a hot topic for different research groups around the world, and the interest is escalating with the increased demand from clinicians. However, no such cement was commercially available at the start of this research project. One of the main difficulties lies in developing a cement with a satisfactory biocompatibility and biostability whilst mitigating the effects of the high stiffness. Furthermore, the cement should have similar handling properties and a similar chemistry to existing products in order to facilitate clinical acceptance and shorten the path to commercialization. We have managed to develop a bone cement, based on PMMA, with a lower stiffness, closer to that of osteoporotic bone, which has shown appropriate handling properties and in vitro biocompatibility. We have also shown its adequacy in biomechanical ex vivo tests in human bone, where a restoration of vertebral strength could be achieved, without an increase in overall stiffness of the vertebra.
The Marie Curie reintegration grant has enabled this project, which has served as the basis for a successful re-establishment of the research fellow in her home country. The grant also permitted the formation of a long-term collaboration between the fellow’s previous host, University of Leeds, and the new host, Uppsala University, which is now based on further funding from the EU (under FP7, NMP theme – LifeLongJoints GA 310477) for a collaborative project between the institutions (and others) that will ensure further exchange of knowledge in biomaterials and biomechanics in the coming 5 years. Subsequent to the Marie Curie award, further funding for the present project was received from the Swedish Innovation Agency, VINNOVA, which assisted in ensuring a stable position for the fellow at the new host. Since the start of the project the fellow has been awarded more than 900k€ as main applicant, from national and European funding sources, and 1.2M€ as co-applicant, from the EU FP7 project initiated by the new and previous host, worth 18M€ with 13.3M€ EU funding to whole consortium. She has also advanced from academic researcher to lecturer and there is an excellent possibility for the fellow for further career advancement at the host - a promotion to senior lecturer is envisaged within the next three years.
In summary, this project has been successful both in terms of the scientific activity as well as the re-integration aims of the scheme. The scientific results, if commercialized, could assist in decreasing the occurrence of painful vertebral fractures, experienced by the osteoporotic population.