Vertebral body reconstruction using antibiotic impregnated bone cement (PMMA) in osteomyelitis of lumbar spine: Case reports

Abstract

Osteomyelitis has long been one of the most common, difficult and challenging problem confronted by the surgeons in daily practice. The key to successful management is early diagnosis and appropriate treatment. The first line in treatment of vertebral osteomyelitis is conservative. There is an increased risk of deep infection with the use of spinal instrumentation. Therefore, the placement of implants in an infected area remains a matter of debate. We present two patients with lumbar vertebral osteomyelitis using antibiotic impregnated PMMA for vertebral body reconstruction and pedicle screw fixation. Post-operative follow-up showed satisfactory results both symptomatically and neurologically. The antibiotic impregnated bone cement acts as both interbody spacer and an antibiotic carrier. However, a long term outcome in both the cases requires further evaluation.

Modified Bone Cement: A Reprieve for Horizontal Bone Defects

“…4,5 The use of PMMA bone cement in orthopedic surgery is a time-proven and effective treatment modality for vertebral body reconstruction, total joint arthroplasty, repair of open fractures, etc. 7,8 The interface integrity of the material can be considered a valuable asset in its use as a bone cement. 8 The same property can be considered pivotal in its use as a material to reconstruct the horizontal ridge defect.…”