The Use of Acrylic Plastic for Vertebral Replacement or Fixation in Metastatic Disease of the Spine

Abstract

RYLIC plastics have been used extensively in the repair of skull defects 10.12 and have been tried not too successfully as replacement therapy for worn-out intervertebral discs, 2,'~ for internal fixation in fractures, and in arthritic spines?-4,7-9,n Dott of Edinburgh 3 mentioned his use of acrylic plastic in atlanto-axial subluxation from rheumatoid arthritis, and his associate Harris ~ has written of further uses including the fixation of fractures of the cervical spine. Clinical and aninml work has shown that acrylic plastic properly used is no more irritating than vitalium or stainless steel and that the heat of polymerization is a handicap only when in direct contact with delicate nerve structures or when uncooled by cold saline irrigation. With these facts in mind, it occurred to us that acrylic polymer might well constitute a rapid method of vertebral internal fixation or replacement in spinal metastatic disease where the patient has only a limited life expectancy and should not spend his last months immobilized in bed in casts or traction. This is a preliminary report on its trial in three such cases, plus confirmatory animal studies. Case Reports Case 1. A 59-year-old woman had metastatic breast carcinoma with lytie collapse of the ~nd cervical vertebra and cord compression. She was hospitalized on April 11, 1963. She had severe neek pain and pyramidal tract signs. There was also metastatic invasion of the skull, lower cervical spine, skin, and liver.

Single stage corpectomy and instrumentation in the treatment of pathological fractures in the lumbar spine

“…Defect-restoration with bone cement or a cage is a an accepted method [2,9,10,11,23]; however, the instrumentation needed to achieve sufficient stability following lumbar corpectomy is controversial. Biomechanical studies revealed that the highest achievable stability is provided by dorso-ventral instrumentation [11,15], but it remains unclear what degree of stiffness is needed to provide osseous healing.…”

“…The defect can be restored using bicortical bone graft or, in case of vertebral metastasis, with bone cement [9,10].…”

Atlanto-Axial Fusion in Rheumatoid ArthritisA New Method of Fixation with Wire and Bone Cement

“…A suitable technique was initially described for metastatic disease of the spine by Scoville et al (1967) and consists in wiring of laminae to occiput and acrylic plastic encasement of wires, occiput and spinous processes. The technique employed in the present series of patients is slightly altered.…”

Cervical Spine Surgery: An Historical Perspective

“…In 1959, Knight [48] described five patients with cervical spondylosis, chronic fracture-dislocation, and atlantoaxial subluxation in rheumatoid arthritis whose cervical spine he fixed with acrylic cement. Scoville et al [73] in 1967 reported use of methylmethacrylate in patients with metastatic tumors of the cervical spine and spinal cord compression. They filled the anterior vertebral-body defects with methacrylate, without intending it as internal fixation.…”