Epidural Temperature Changes During Anterior Cervical Interbody Fusion With Polymethylmethacrylate

Cervical spondylomyelopathy

“…The dorsal anulus must be left intact to prevent cement from entering the vertebral canal. If the anulus is torn, it is possible to protect the dura prior to introducing cement using Gelfoam (Pharmacia, Kalamazoo, MI) as this has good thermo-insulating properties (Roosen et al, 1978;Boker et al, 1989). Distraction can be done using Gelpi retractors in the vertebral bodies as shown in 11.38A (Dixon et al, 1996) but ideally not by placing a retractor in the adjacent disc spaces (Bruecker et al, 1989a;Dixon et al, 1996;Wilson et al, 1994) (11.13A).…”

“…Gelfoam (Pharmacia, Kalamazoo, MI) can be used to insulate the graft as the cement hardens (Roosen et al, 1978;Boker et al, 1989). If pins or screws are to be combined with a ventral slot it is important to position the screws precisely as there is only a limited amount of bone available.…”

Neoplasia

“…Ideally, some stabilization must also be provided to dorsal spinal elements. This could be fashioned from cement although thermal injury to the spinal cord must be avoided, such as by using Gelfoam (Roosen et al, 1978;Boker et al, 1989). An alternative is to add modified segmental fixation (12.41).…”

Radiologic long-term results after cervical vertebral interbody fusion with Polymethyl Methacrylat (PMMA)

“…This is thought to be due to the excellent thermo-insulating ability of the gelfoam which is routinely used to cover the dura and the nerve roots prior to introduction (pouring) of P M M A into the intervertebral space [10].…”