Long-term clinical complications associated with the use of polymethyl methacrylate in spinal stabilization of dogs and cats: case series

Abstract

Vertebral and spinal cord trauma are common conditions in small animal practice and often result in vertebral fractures/luxation (VFL) with concomitant spinal cord laceration, concussion, compression, or ischemia. These lesions have several clinical presentations that may vary from moderate to severe pain and partial to total loss of motor, sensory, and visceral functions, which may result in death or euthanasia. Our purpose is to describe five cases (four dogs and one cat) of complications secondary to the use of bone cement for vertebral stabilization. The patients, between five months and four years of age and weighing between 1.4 and 12.2 kg, were referred to the Small Animal Orthopedics and Traumatology Service of the Veterinary Hospital of the College of Veterinary Medicine and Animal Science of the University of São Paulo. They had a history of post-operatory polymethyl methacrylate (PMMA) reactions (such as drainage or cement exposure due to infection or implant failure) in periods from 9 to 18 months after undergoing spinal osteosynthesis. Surgical implant removal occurred in 80% of the patients (4/5). Complete remission was not observed in the patient with residual implants. The association of pins/screws and PMMA is a versatile osteosynthesis technique and is applicable in all spinal regions. However, delayed complications can occur, which could require additional surgical procedures. Despite the small number of cases included in this study, one can infer that complications related to the use of bone cement in spinal surgery can occur in the long term and should be highlighted during the implant choosing process for vertebral osteosynthesis in small animals.

Explant of a Chronic Atlantoaxial Implant Infection in a Dog

“…The implant was surgically removed and the culture obtained, but the results were not reported in this paper [ 11 ]. In another case series assessing the long-term outcomes of PMMA and pins/screw for spinal stabilization, exposure of the PMMA and/or development of a draining tract was noted in five patients over a span of six months to 1.5 years postoperatively [ 12 ]. Four of the five patients had surgery to remove the implant, and three of the cultures grew E. coli : coagulase-positive Staphylococcus, beta-lactamase Staphylococcus and methicillin-resistant S. aureus (MRSA).…”

Surgical complications associated with hemilaminectomy and intervertebral disc fenestration: Prospective study of 64 dogs

“…The following information was determined during the intraoperative period: procedure time (min); access to the vertebral canal or intervertebral space in the correct location and on the correct side; intervertebral disc material in the canal after fenestration; pneumothorax; cardiac arrest; iatrogenic injury of the spinal cord; and iatrogenic rhizotomy (SHARP & WHEELER, 2005;BRISSON, 2017;HETTLICH, 2017;DIAMANTE et al, 2020;MOORE et al, 2020).…”

Realización De Técnicas Quirúrgicas en Cadáver De Perro Y Modelado Computarizado 3d Para Ilustrar La Estabilización De La Columna Lumbosacra en Caso De Fractura/Luxación

“…Apesar de ser uma das técnicas mais usadas para a correção de fraturas e luxações lombossacras, várias complicações foram descritas, tais como lesão térmica, levando à necrose óssea e afrouxamento dos implantes; risco de infecção pelo fato do cimento ósseo ser poroso; ruptura ou afrouxamento do PMMA; seroma devido à presença de espaço morto e desenvolvimento de ferida aberta no local da cirurgia (Diamante et al, 2020;Vallefuoco et al, 2014). Essas complicações podem ocorrer até mesmo após a alta do paciente e melhora dos sinais clínicos (Diamante et al, 2020).…”