Polymethylmethacrylate-augmented screw fixation for stabilization in metastatic spinal tumors

Jang, Jee Soo; Lee, Sang Ho; Rhee, Chang Hun; Lee, Jun Young

doi:10.3171/spi.2002.96.1.0131

Cited by 14 publications

(8 citation statements)

References 14 publications

(21 reference statements)

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“…Nevertheless, there is frequently a need to use K-wires or screws to improve MMA anchorage to the adjacent VBs. 19 Because MMA may "piston" in the setting of weak bone, the pins may migrate to penetrate vital structures (spinal cord, aorta). The chest tube technique 16 and our own modifications (endplate preparation, then distraction, then placement of MMA against endplates, then compression with ventral or dorsal instrumentation) avoid the use of anchoring pins and their associated risks (Fig.…”

Section: Types Of Reconstructionmentioning

confidence: 99%

Surgical management of metastatic spinal neoplasms

Vrionis¹,

Small²

2003

FOC

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Object In this study the authors retrospectively review outcomes in patients treated for metastases to the spine. Surgery for metastatic tumors to the spine remains an important part of the treatment armamentarium. Maximum tumor resection with a minimum number of complications is one of the goals of surgery. Current surgical procedures include tumor resection and spinal stabilization for optimal results. Methods The records of 96 patients who underwent surgery for a metastatic spine tumor at the authors' institution were reviewed. Spinal instrumentation was used in the majority of patients. Ambulatory status was maintained in 91% and pain improved in 94% of patients. Complications included infection (5.2%), cerebrospinal fluid leak (2%), and delayed hardware failure (3.1%). The mortality rate was 4.1%; the main cause was due to tumor progression. Conclusions Surgery is indicated in a select group of patients with metastatic tumors to the spine. A multidisciplinary approach is recommended for patient selection and complication avoidance. Surgical options, including approach, type of reconstruction and extent of resection (including en bloc spondylectomy) need to be addressed for optimal outcomes.

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Section: Types Of Reconstructionmentioning

confidence: 99%

Surgical management of metastatic spinal neoplasms

Vrionis¹,

Small²

2003

FOC

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“…PMMA bone cement has been used to augment screw fixation in spine [4,10,16,18,19,22] and trauma [3,7,15,17] applications. These studies all showed increases in failure strength of constructs augmented with PMMA.…”

Section: Introductionmentioning

confidence: 99%

Bioabsorbable Tricalcium Phosphate Bone Cement Strengthens Fixation of Suture Anchors

Oshtory¹,

Lindsey

Giori

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Failure of suture anchor fixation in rotator cuff repair can occur at different interfaces. Prior studies show fixation at the bone-anchor interface can be augmented using polymethylmethacrylate (PMMA) cement, and screw fixation into bone can be strengthened using bioabsorbable tricalcium phosphate cement. Questions/purposes We wished to determine whether augmentation of suture anchor fixation using bioabsorbable tricalcium phosphate cement would increase pullout strength of suture anchors from bone and the number of cycles to failure, to determine the mode of failure after cement augmentation, and to compare strength and mode of failure with those after augmentation with PMMA.Methods We used 10 matched pairs of cadaveric proximal humeri and implanted a metal screw-type suture anchor in one side and on the other side injected tricalcium phosphate cement into the anchor holes before anchor placement. We tested all specimens to failure using a ramped cyclic loading protocol. Results Tricalcium phosphate cement augmentation increased the final load to failure by 29% and the number of cycles to failure by 20%. Visual inspection confirmed that failure occurred at the cement-bone interface. Conclusions Tricalcium phosphate cement appears to augment suture anchor fixation into bone, reducing the risk of anchor pullout and failure. Clinical Relevance When relying on suture anchor fixation in bone of questionable quality, we suggest considering augmentation of suture anchor fixation with bioabsorbable cement. This method also provides potential for bioabsorbability and may be more amenable to arthroscopic application.

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“…2 PMMA has had limited use as a reconstructive and stabilizing material in the treatment of cervical spine degenerative diseases, but has been recently used for the treatment of osteoporosis fractures. 15,16 For a bone graft to be successful, three processes, osteogenesis, osteoconductivity, and osteoinductivity, which mimic the natural events that occur in cancellous bone, must take place. 10,11 We simulated the combined characteristics of bone grafts and cages by using shaped hollow bone cement filled with impacted cancellous bone as a substitute for structural bone graft.…”

Section: Discussionmentioning

confidence: 99%