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Critical Review of the State-of-the-Art on Lumbar Percutaneous Cement Discoplasty

Interbody fusion is the gold standard surgery to treat lumbar disc degeneration disease but can be a high-risk procedure in elderly and polymorbid patients. Percutaneous Cement Discoplasty (PCD) is a minimally invasive technique developed to treat advanced stage of disc degeneration exhibiting a vac...

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Autores principales: Techens, Chloé, Eltes, Peter Endre, Lazary, Aron, Cristofolini, Luca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9127498/
https://www.ncbi.nlm.nih.gov/pubmed/35620196
http://dx.doi.org/10.3389/fsurg.2022.902831
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author Techens, Chloé
Eltes, Peter Endre
Lazary, Aron
Cristofolini, Luca
author_facet Techens, Chloé
Eltes, Peter Endre
Lazary, Aron
Cristofolini, Luca
author_sort Techens, Chloé
collection PubMed
description Interbody fusion is the gold standard surgery to treat lumbar disc degeneration disease but can be a high-risk procedure in elderly and polymorbid patients. Percutaneous Cement Discoplasty (PCD) is a minimally invasive technique developed to treat advanced stage of disc degeneration exhibiting a vacuum phenomenon. A patient-specific stand-alone spacer is created by filling the disc with polymethylmethacrylate cement, allowing to recover the disc height and improve the patient’s conditions. As it has recently been introduced in the lumbar spine, this review aims to present a transversal state-of-the-art of the surgery from its clinical practice and outcome to biomechanical and engineering topics. The literature was searched across multiple databases using predefined keywords over no limited period of time. Papers about vertebroplasty were excluded. Among 466 identified papers, the relevant ones included twelve clinical papers reporting the variations of the surgical technique, follow-up and complications, four papers reporting biomechanical ex vivo and numerical tests, and four letters related to published clinical papers. Papers presenting the operative practice are reported, as well as follow-ups up to four years. The papers found, consistently reported that PCD significantly improved the clinical status of the patients and maintained it after two years. Spine alignment was impacted by PCD: the sacral slope was significantly reduced, and disc height increased. The foramen opening correlated to the volume of injected cement. Substitutes to the acrylic cement exhibited better osteointegration and mechanical properties closer to bone tissue. Finally, limitations and risks of the surgery are discussed as well as potential improvements such as the development of new filling materials with better mechanical properties and biological integration or the investigation of the inner disc.
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spelling pubmed-91274982022-05-25 Critical Review of the State-of-the-Art on Lumbar Percutaneous Cement Discoplasty Techens, Chloé Eltes, Peter Endre Lazary, Aron Cristofolini, Luca Front Surg Surgery Interbody fusion is the gold standard surgery to treat lumbar disc degeneration disease but can be a high-risk procedure in elderly and polymorbid patients. Percutaneous Cement Discoplasty (PCD) is a minimally invasive technique developed to treat advanced stage of disc degeneration exhibiting a vacuum phenomenon. A patient-specific stand-alone spacer is created by filling the disc with polymethylmethacrylate cement, allowing to recover the disc height and improve the patient’s conditions. As it has recently been introduced in the lumbar spine, this review aims to present a transversal state-of-the-art of the surgery from its clinical practice and outcome to biomechanical and engineering topics. The literature was searched across multiple databases using predefined keywords over no limited period of time. Papers about vertebroplasty were excluded. Among 466 identified papers, the relevant ones included twelve clinical papers reporting the variations of the surgical technique, follow-up and complications, four papers reporting biomechanical ex vivo and numerical tests, and four letters related to published clinical papers. Papers presenting the operative practice are reported, as well as follow-ups up to four years. The papers found, consistently reported that PCD significantly improved the clinical status of the patients and maintained it after two years. Spine alignment was impacted by PCD: the sacral slope was significantly reduced, and disc height increased. The foramen opening correlated to the volume of injected cement. Substitutes to the acrylic cement exhibited better osteointegration and mechanical properties closer to bone tissue. Finally, limitations and risks of the surgery are discussed as well as potential improvements such as the development of new filling materials with better mechanical properties and biological integration or the investigation of the inner disc. Frontiers Media S.A. 2022-05-10 /pmc/articles/PMC9127498/ /pubmed/35620196 http://dx.doi.org/10.3389/fsurg.2022.902831 Text en Copyright © 2022 Techens, Eltes, Lazary and Cristofolini. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Techens, Chloé
Eltes, Peter Endre
Lazary, Aron
Cristofolini, Luca
Critical Review of the State-of-the-Art on Lumbar Percutaneous Cement Discoplasty
title Critical Review of the State-of-the-Art on Lumbar Percutaneous Cement Discoplasty
title_full Critical Review of the State-of-the-Art on Lumbar Percutaneous Cement Discoplasty
title_fullStr Critical Review of the State-of-the-Art on Lumbar Percutaneous Cement Discoplasty
title_full_unstemmed Critical Review of the State-of-the-Art on Lumbar Percutaneous Cement Discoplasty
title_short Critical Review of the State-of-the-Art on Lumbar Percutaneous Cement Discoplasty
title_sort critical review of the state-of-the-art on lumbar percutaneous cement discoplasty
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9127498/
https://www.ncbi.nlm.nih.gov/pubmed/35620196
http://dx.doi.org/10.3389/fsurg.2022.902831
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