Vertebroplasty is a new technique in orthopedic surgery for stabilizing fractured vertebra. In this technique acrylic bone cement as a biocompatible material is injected through a cannula inside of vertebra. There are several concerns in this technique that the most serious one is cement leakage out of vertebra. The main reasons are improper viscosity and lack of visibility. Clinicians who practice vertebroplasty use commercial highly concentrated radiopaque acrylic bone cement (more than 25%BaSO[subscript 4] or ZrO[subscript 2]) or a cement with manually added radiopaque agents. High density materials with attenuation under X-ray are good alternatives compared to conventional radiopaque agents (BaSO[subscript 4] or ZrO[subscript 2]) in acrylic bone cement for application in vertebroplasty. In the first part of this study, thermal and rheological properties of modified acrylic bone cement with conventional radiopaque agent (Barium Sulfate, BaSO[subscript 4]) are studied. Additions of barium sulfate are in the form of substitute or excess. In substitute formulation, barium sulfate is replaced with the same weight of powder and liquid to powder ratio kept constant. In the excess formulation, barium sulfate added as excess and liquid to powder ratio decreased. In the second part of this study, high density radiopaque agents are used as alternative radiopacifier. Experimental design technique is used to study the effect of X-ray conditions, concentration, type, and size of radiopaque agents on the visibility of bone cement. The visibility of bone cement was quantified by the measurement of contrast index. In the first project, it was found that the setting time increased with the increase of concentration of radiopacifier in substitute formulation of barium sulfate bone cement. With increase of barium sulfate concentration, excess formulations showed higher residual monomer but for substitute cement, we had a decreasing trend. Acrylic bone cements with excess formulation had higher initial viscosity compared to reference or substitute but the variation of viscosity with time was lower for substitute formulation and cements had higher working time. In the second project, contrast index was the same for barium sulfate, tungsten, and zirconium in the lower voltage but in higher voltage of X-ray lamp, tungsten and zirconium gave higher contrast index. Variation of current in X-ray lamp changed the contrast index of cement slightly compared to the effect of voltage. Bone cement with nano tungsten had higher contrast index compared to the cement with micro size tungsten although micro size zirconium as radiopacifier gave higher contrast index than nano size zirconium.

Akrylbaserat bencement är den gyllene standarden vid ryggförstärkningsförfaranden. Modifiering av akrylbencement med linolsyra har resulterat i attraktiva egenskaper vilka möjliggör lättare hantering för kirurger och minskar efterföljande komplikationer såsom närliggande ryggradsfrakturer. Även om de attraktiva egenskaperna hos linolsyramodifierat bencement är kända är ännu förståelsen för hur linolsyra påverkar egenskaperna outforskade. Som en komponent i bencement måste linolsyra steriliseras innan den används i bencement. Det finns emellertid oro för att autoklavsterilisering av linolsyra orsakar nedbrytning. Dessutom är det oklart vad som händer med linolsyra i härdat bencement över tid. I detta examensarbete utvärderades steriliserad och osteriliserad linolsyra. Linolsyra blandades med olika komponenter som finns i bencementet såsom aktivator, initiator, monomer och inhibitor, i närvaro och frånvaro av lösningsmedel. De efterföljande förändringarna studerades genom 1H NMR och UV-VIS. Resultaten visade att linolsyra bryts ned av sterilisering och oxidation. Oxidationen av linolsyra berodde på sterilisering, temperatur, lösningsmedel och mängden syrexponering. Det bekräftades genom 1H NMR och UV-VIS att linolsyra reagerade (steriliserad och osteriliserad) med aktivatorn, initiatorn och monomeren. Dessa reaktioner kan minska tillgängligheten av komponenterna för in situ-polymerisation av monomeren, och därmed förändra bencementens egenskaper, vilket i sin tur bidrar till lättare hantering under förstärkningsförfarandet och reducerar intilliggande ryggradsfrakturer efter operation. / Acrylic bone cement is the gold standard in vertebral augmentation procedures. Modification of acrylic bone cement using linoleic acid has resulted in attractive properties that enable convenient handling by surgeons and reduce follow-up complications such as adjacent vertebral fractures. Even though the attractive properties of linoleic acid-modified bone cement are acknowledged, the understanding of how it imparts those properties remain unexplored. As a component in bone cement, linoleic acid needs to be sterilized before its use in bone cement. However, there are apprehensions whether autoclave sterilization of linoleic acid causes degradation. In addition, it is unclear what happens with linoleic acid in hardened bone cement over time.  In this thesis, sterilized and unsterilized linoleic acid were evaluated alone and treated with different components of the bone cement such as activator, initiator, monomer, and inhibitor, in the presence and absence of solvent, and the ensuing changes were monitored through 1H NMR and UV-VIS. The results showed that linoleic acid degraded due to sterilization and oxidation. The oxidation of linoleic acid depended on sterilization, temperature, solvent, and the amount of oxygen exposure. As confirmed through 1H NMR and UV-VIS, linoleic acid (sterilized and unsterilized) reacted with the activator, initiator, and monomer. These reactions could reduce the availability of the components for the in-situ polymerization of the monomer, thus altering the properties of the bone cement including convenient handling during the operation and reduced adjacent vertebral fractures post the operation.

Die vorliegende Arbeit befasst sich mit der kontinuumsmechanischen Formulierung des Aushärteverhaltens polymerer Werkstoffe sowie der Implementierung und Simulation von Aushärtestoffgesetzen im Rahmen der Finite-Elemente-Methode. Auf Basis eines allgemeinen Modellierungsrahmens wird ein konkretisiertes Stoffgesetz für die Nachbildung von Aushärteprozessen eines acrylischen Knochenzements entwickelt. Darüber hinaus werden verschiedene Finite-Elemente-Simulationen zum klinischen Verfahren der Vertebroplastie präsentiert. / This work deals with the continuum mechanical formulation of curing phenomena in polymers as well as the implementation and simulation of curing models within the finite element method. Based on a general modelling framework, a specified material model for the simulation of curing processes in an acrylic bone cement is developed. Moreover, different finite element simulations regarding the clinical procedure of vertebroplasty are presented.

Die vorliegende Arbeit befasst sich mit der kontinuumsmechanischen Formulierung des Aushärteverhaltens polymerer Werkstoffe sowie der Implementierung und Simulation von Aushärtestoffgesetzen im Rahmen der Finite-Elemente-Methode. Auf Basis eines allgemeinen Modellierungsrahmens wird ein konkretisiertes Stoffgesetz für die Nachbildung von Aushärteprozessen eines acrylischen Knochenzements entwickelt. Darüber hinaus werden verschiedene Finite-Elemente-Simulationen zum klinischen Verfahren der Vertebroplastie präsentiert. / This work deals with the continuum mechanical formulation of curing phenomena in polymers as well as the implementation and simulation of curing models within the finite element method. Based on a general modelling framework, a specified material model for the simulation of curing processes in an acrylic bone cement is developed. Moreover, different finite element simulations regarding the clinical procedure of vertebroplasty are presented.