Infection following surgery can result in significant
pain and morbidity for patients undergoing
vertebroplasty/
kyphoplasty, and often results in
revision surgery. This study focuses on the development of Al-free
glass polyalkenoate cements (GPCs) based on 0.04SrO-0.12CaO-0.36ZnO-0.48SiO( 2) glass, with the intent of optimizing their antibacterial efficacy by incorporating low-molecular-weight polyacrylic
acids (PAA) and
trisodium citrate (
TSC), and evaluating the resultant GPCs against bacteria relevant to spinal
infections, P. aeruginosa and E. coli. Ion-release profiles were determined for the GPC formulation containing E6 PAA (Cement A) and E7 PAA (Cement B), and Zn, Na, and Sr release was recorded over 1, 7, and 30 days. Inhibition was found in E. coli at each time period (0-30 days) and this generally decreased with exposure time in water. The largest GPC inhibition zones were produced by Cement A (6 mm); however the control material
Simplex P +
tobramycin produced much higher inhibition zones (11 mm). When testing the GPC against P. aeruginosa, inhibition was only present at the 0-day time period.
Simplex P +
tobramycin was found to produce inhibition at each time frame. Analysis of the
agar from the inhibition zone of the E. coli test revealed that there is a significant change in Zn concentration as compared to a control
agar specimen, which suggests that Zn release is responsible for the antibacterial effect of the GPCs.