Surgical Applications of PMMA

Generally, vertebral compression fractures are a consequence of osteoporosis, a disease characterized by a decrease in bone mass and a micro-architectural weakening of bone tissue. Considering that vertebral column is a complex structure whose aim is to provide mobility, flexibility and support to the upper part of the human body along with protection to the spinal cord maintaining as well as restoring it to its natural shape is essential. In particular, the vertebral body bears up to 20% of the compressive force supported by the human body [26]. Computed tomography scans of fractured 

Taking into account that both procedures are minimally invasive, bacterial infection is rare. However, some cases have been reported [28-30], and several authors have suggested the use of antibiotic-loaded bone cements in order to prevent this complication [31]. 

Taking in consideration that osteoplasty is generally related to the appearance of tumors in bone tissue, the use of chemotherapeutic drug-loaded bone cement is being evaluated. In this sense the same principles for antibiotic-loaded bone cement are applied. Several studies have been carried out in order to determine the elution profile of different drugs with potential or proven antitumoral activity. Zwolak et al. [36] studied both the release profile and cytotoxic effect of zoledronic acid-loaded bone 

In a one-stage procedure of an infected arthroplasty, the infected implant is removed, the compromising tissue is debrided, and a new prosthesis is inserted during the same operative session with a systemic antibiotic treatment after surgery [43]. 

A two-stage procedure consists of the removal of infected implant, tissue and the cement during the first stage, followed by the insertion of a temporary spacer. In the second stage, after infection has healed, the spacer is removed and replaced with the definitive prosthesis. 

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