Polymethyl Methacrylate (PMMA) Cement as an Interbody Spacer in Pyogenic Spondylodiscitis: Results of a Scoping Review

Authors

• Daniel W. Griepp, Henry Ford HealthFollow
• Adam Mansour, Henry Ford HealthFollow
• Jeffrey Turnbull, Henry Ford HealthFollow
• Ammar H. Alsalahi, Henry Ford HealthFollow
• Bryce K. Sarcar, Henry Ford HealthFollow
• Shivum A. Desai, Henry Ford HealthFollow
• Julio Rosado-Philippi, Henry Ford HealthFollow
• Ishan Perera, Henry Ford HealthFollow
• Avery Roe, Henry Ford HealthFollow
• Doris Tong, Henry Ford Health
• Heather Heitkotter, Henry Ford HealthFollow
• Jake M. Jasinski, Henry Ford HealthFollow
• Chad F. Claus, Henry Ford HealthFollow
• Clifford M. Houseman, Henry Ford HealthFollow
• Prashant S. Kelkar, Henry Ford HealthFollow
• Peter Bono, Henry Ford HealthFollow
• Teck M. Soo, Henry Ford Health
• Boyd F. Richards, Henry Ford HealthFollow
• Daniel A. Carr, Henry Ford HealthFollow

Recommended Citation

Griepp DW, Mansour A, Turnbull JP, Alsalahi A, Sarcar BK, Desai S, Rosado Philippi J, Perera I, Roe A, Tong D, Heitkotter H, Jasinski JM, Claus CF, Houseman CM, Kelkar PS, Bono P, Soo TM, Richards BF, Carr DA. Polymethyl Methacrylate (Pmma) Cement as an Interbody Spacer in Pyogenic Spondylodiscitis: Results of a Scoping Review. Global Spine J. 2026;21925682261485875.

Document Type

Article

Publication Date

9-1-2026

Publication Title

Global Spine J

Abstract

Study Design: Scoping review.ObjectiveTo systematically map and characterize the literature on the use of polymethyl methacrylate (PMMA) cement as an interbody spacer in the surgical management of pyogenic spondylodiscitis.

Methods: A comprehensive search of MEDLINE, EMBASE, Web of Science, and Cochrane Library databases was conducted from their inception through February 2026. Studies reporting PMMA cement used as an interbody for pyogenic spondylodiscitis were included. Postoperative surgical site infections were excluded. Data were synthesized descriptively following scoping review framework (PRISMA-ScR).

Results: Eight studies involving 203 patients (2013-2024) were identified. Common surgical indications included neurological deficit, instability, epidural abscess, and failure of medical management. Antibiotic-impregnated PMMA was used in seven studies (most commonly vancomycin + tobramycin or gentamicin). No major PMMA-related complications were reported, although one study mentioned a case of PMMA implant dislocation, requiring revision surgery during the same admission. Infection recurrence was low (1.4-1.6%). Fusion rates ranged from 95.9% to 100% when assessed (n=150). Fusion was commonly observed despite permanent PMMA implantation. Patient-reported outcomes were infrequently assessed but reported improvements in pain scores.

Conclusions: Limited level IV evidence suggests that antibiotic-impregnated PMMA interbody placement is associated with high rates of infection control and fusion in pyogenic spondylodiscitis, particularly when significant endplate destruction is present and anterior column support is needed. No major PMMA-related complications were reported in the available literature. Well-designed comparative studies are warranted to clarify optimal patient selection, long-term durability, and the relative advantages of PMMA, if any, over contemporary reconstructive techniques.

PubMed ID

42677913

First Page

21925682261485875

Last Page

21925682261485875