Novel biodegradable electrospun nanofibrous P(DLLA-CL) balloons for the treatment of vertebral compression fractures

Significant interest has been expressed by the spinal surgeon community for the use of calcium phosphate cement (CPC) in the treatment of vertebral compression fractures (VCFs), but the water-induced collapsibility and poor mechanical properties limit its clinical use. Here we fabricated novel electrospun nanofibrous P(DLLA-CL) balloons (ENPBs) using the nanotechnique of electrospinning. The ENPBs could separate the cements from the surrounding environment, and therefore can prevent the water-induced collapsibility of CPC and eliminate cement leakage. The ENPBs filling with CPC had enough load-bearing ability to restore the height of the fractured vertebral body and had no obvious effects on the initial strength and stiffness of natural bones. Further, the ENPBs had good biodegradability and cell proliferation ability. Calcium can be released from ENPBs filling with CPC. All these results strongly demonstrate ENPBs can be potentially used as CPC filling containers that keep the advantages and eliminate the disadvantages of CPC.From the Clinical EditorCalcium phosphate cement (CPC) is a promising modality in vertebral compression fracture treatment, but its water-induced collapsibility limits clinical applications. This team of investigators fabricated novel nanofibrous balloons using electrospinning, which enabled the separation of CPC from its surrounding environment, and therefore prevented water-induced collapsibility of CPC and eliminated cement leakage while maintaining all the advantages of CPC treatment.

Graphical AbstractBiodegradable electrospun nanofibrous P(DLLA-CL) balloons (ENPBs) were developed using the nanotechnique of electrospinning. Using different custom-designed Ti alloy moulds, ENPBs with different shapes/sizes could be easily prepared. The ENPBs can separate cements from the surrounding environment, eliminate the cement leakage, and prevent water-induced collapsibility. Moreover, the ENPBs filling with CPC had enough load-bearing ability to restore the height of the fractured vertebral body and may not induce the adjacent-level fracture risk. Therefore, the ENPBs can potentially be used as CPC filling containers for the treatment of vertebral compression fractures.Figure optionsDownload high-quality image (153 K)Download as PowerPoint slide