Hollow bone cement filled with impacted cancellous bone as a substitute for bone grafts in cervical spine fusion

Pan, Hung-Chuan; Wang, Yeou-Chih; Lee, Cheng-Hung; Yang, Dar-Yu

doi:10.1016/j.jocn.2005.11.049

Cited by 10 publications

(13 citation statements)

References 14 publications

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“…Necrosis of adjacent vertebrae and limited ventral ossification were also noted [17]. Some authors have investigated the modification of PMMA into a cage structure filled with autologous cancellous bone, reporting successful fusion rates with limited donor site morbidity [24,67].…”

Section: Polymethylmethacrylate (Pmma)mentioning

confidence: 99%

Bone graft substitutes in anterior cervical discectomy and fusion

2009

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Anterior cervical discectomy with fusion is a common surgical procedure for patients suffering pain and/ or neurological deficits and unresponsive to conservative management. For decades, autologous bone grafted from the iliac crest has been used as a substrate for cervical arthrodesis. However patient dissatisfaction with donor site morbidity has led to the search for alternative techniques. We present a literature review examining the progress of available grafting options as assessed in human clinical trials, considering allograft-based, synthetic, factor-and cell-based technologies.

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Section: Polymethylmethacrylate (Pmma)mentioning

confidence: 99%

Bone graft substitutes in anterior cervical discectomy and fusion

2009

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“…Reconstruction of the defect after discectomy is still a matter of debate among spine surgeons. Autogenous tricortical iliac graft, femoral ring allograft, bone cement, artificial disc, PEEK cages and titanium cages have all been applied [2,4,7,12,13,17,23]. However, the choices become limited in fourlevel disease.…”

Section: Introductionmentioning

confidence: 99%

Four-level anterior cervical discectomies and cage-augmented fusion with and without fixation

2012

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Purpose Anterior cervical decompression and fusion is a well-established procedure for the treatment of cervical spinal canal stenosis. In this study, we evaluated the necessity of spinal instrumentation after four-level anterior cervical decompression and cage fusion. Methods From January 2006 until August 2008, 25 patients (8 females and 17 males) (mean age 63.9 ± 7.9 years) suffering from spinal stenosis C3-C7 underwent anterior decompression and interbody fusion. The patients were divided into two groups. Four-level discectomy and cage fusion was performed in all patients. In group A including nine patients, posterior instrumentation with a lateral mass screw-rod system was added, while in group B including 16 patients, additional instrumentation was not performed. The mean duration of follow-up was 48.6 months (average 25-67 months). Results Clinically, the mean value for the Neck Disability Index improved from 40 ± 23.25 at presentation to 16.31 ± 15.09 at the final follow-up. The difference between the two groups was statistically not significant. Radiologically, the criteria for solid bony fusion were achieved successfully in all patients of group A, and in 87.5 % of patients in group B. The difference between the two groups was statistically not significant. The fused segment was then evaluated in the sagittal radiographs as regards the height and the lordosis angle. The loss in the height as well as the loss in the lordosis angle was more when posterior instrumentation was not added. However, the difference between the two groups was not statistically significant. Conclusion Stand-alone intersomatic cage fusion is an acceptable line of treatment for four-level cervical disc disease, both clinically and radiologically. Although the addition of posterior instrumentation yields better radiological results, the difference does not reach the statistical significance level.

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“…As a framework assisting the cancellous bone in connection with the two adjacent vertebral bodies, the complex folding of polymers of PMMA can postulate its collapse in body. Thus it is an advantage over autografts (20).…”

Section: Resultsmentioning

confidence: 99%

Application of a crescent-shaped pmma strut in anterior spinal reconstruction of thoracolumbar and lumbar burst fractures: a new technique

Wan

Kang²,

Fei³

2011

Turkish Neurosurgery

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AIm: Our aim was to evaluate the safety and efficacy of the novel crescent-shaped PMMA strut for anterior spinal reconstruction and fusion in patients with thoracolumbar bust fractures. The surgical results using this technique are reviewed. mAterIAl and methOds: Six patients suffering thoracolumbar and lumbar fracture using a crescent-shaped PMMA strut combined with fixation for reconstruction of the anterior spinal column. Postoperative radiographic, included plain x-ray and 3-D computed tomography (CT) imaging, evaluated fusion status postoperatively. Pain relief and neurological status was assessed by comparing Frankel Score and Vision Analogue Score (VAS) pre-and postoperatively.results: All six patients achieved immediate stabilization. No patient needs additional posterior instrumentation stabilization due to loss of sagittal alignment and kyphosis deformity. All patients achieved significant relief of back pain, improvement of neurological function, correction of preoperative deformity and excellent bone fusion results documented on plain x-rays and 3-D CT reconstruction imaging. There were no complications of neurological worsening, wound infection, subsidence and dislodgement of PMMA strut, or anterior instrumentation failure during the follow-up. COnClusIOn:The crescent-shaped PMMA strut is an alternative for anterior spinal reconstruction and fusion in patients with thoracolumbar burst fracture. However, the long-term clinical effects and possible complications need further evaluation.KeywOrds: Burst fracture, Polymethylmethacrylate, Crescent-shaped, Anterior reconstruction ÖZ AmAÇ: Torakolomber bölgede patlama kırığı olan hastalarda rekonstrüksiyonu ve füzyonu sağlamak için kullanılan polimetilmetakrilattan yapılma, hilal şeklinde olan yapının etkinliğinin ve güvenilirliğinin saptanması için bu tekniğin kullanıldığı hastaların cerrahi sonuçlarının ortaya konması. yÖntem ve GereÇler: Polimetilmetakrilattan yapılma, hilal şeklindeki enstrüman, torakolomber bölgede patlama kırığı olan 6 hastada anterior kolonun rekonstrüksiyonunu ve füzyonunu sağlamak için kullanılmıştır; bu hastalara aynı zamanda stabilizasyon işlemi de yapılmıştır. Radyolojik olarak; düz grafiler ve 3 boyutlu bilgisayarlı tomografilerle füzyon ve rekonstrüksiyon gelişimi incelenmiştir. Ayrıca tüm hastalara ameliyat öncesi ve sonrası dönemde Frankel ölçütlemesi ve Görsel ağrı ölçütlemesi yapılmıştır.BulGulAr: Tüm hastalarda erken dönemde stabilizasyon gerçekleşmiştir. Hastaların hiçbirinde sagital plan bozulması ve kifoz gelişimi olmamıştır, bu nedenle fazladan bir posterior stabilizasyona gerek duyulmamıştır. Üç boyutlu bilgisayarlı tomografi ve normal x-ray grafilerinde hastalarda mükemmel füzyon geliştiği ve deformitelerinin düzeldiği görüldü; bunun yanı sıra, hastaların hepsinde bel ağrısı geçti, nörolojik fonksiyonları daha iyi hale geldi. Hastalarda nörolojik kötüleşme, Polimetilmetakrilattan yapılma hilal şeklindeki enstrümanın gömülmesi ya da uzerinde çıkması, yara infeksiyonu ve anterior enstrümanın yetmezliği gibi bi...

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Hollow bone cement filled with impacted cancellous bone as a substitute for bone grafts in cervical spine fusion

Cited by 10 publications

References 14 publications

Bone graft substitutes in anterior cervical discectomy and fusion

Bone graft substitutes in anterior cervical discectomy and fusion

Four-level anterior cervical discectomies and cage-augmented fusion with and without fixation

Application of a crescent-shaped pmma strut in anterior spinal reconstruction of thoracolumbar and lumbar burst fractures: a new technique

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