[Acrylic bone cement use for internal spondylodesis in neurosurgical operations]

Vertebral column stabilization relying on performing of surgical internal spondylodesis with acrylic bone cement (methylmethacrylate, MMA) was carried out in 27 cases treated surgically in Department and Clinic of Neurosurgery in Poznań from 1996 to 1999. The age of patients was 16-69 (mean age 50.29 +/- 15.29) years. Male patients predominated (2:1). The vertebral lesion was caused by neoplasm (55% of cases), degenerative disease (26%), trauma (19%). Pathological changes were found in cervical region in 16 (59%), in thoracic region in 6 (22%) and in lumbar region in 5 (19%) patients. The anterior surgical approach to vertebral column was chosen in 17 (63%), posterolateral approach in 8 (30%) and posterior approach in 2 (7%) patients. Bone acrylic cement was used for reconstruction of vertebral body damaged by neoplasm or trauma, whereas it substituted the removed intervertebral disc or vertebral body in degenerative diseases. The acrylic cement graft in all cases maintained the proper anterior and medial vertebral column alignment. Semiliquid acrylic cement was used for filling of defects after tumour removal in thoracic and lumbar vertebral bodies. Acrylic cement graft was properly prepared in cuboid form and was inserted into the intervertebral spaces in patients with trauma or degenerative diseases. In all cases involving bone acrylic cement, stabilization of the vertebral segment was completed by metallic implants (cervical plates, "Z" plates, intrapedicular screws and rods). No postoperative complications (wound infections or implant dislocation) were observed. Postoperative, neurological signs were intensified in 3 cases (12%) and were regressive. Mortality rate was 4%. This type of internal spondylodesis makes possible to restore the anterior and medial columns and immobilisation of the proper vertebral segments.