PCD in the lumbar spine: Is there an optimal injection volume?

Abstract

Cement discoplasty is a minimally invasive surgical technique used to treat low back pain by stabilizing spinal segments through the injection of polymethylmethacrylate (PMMA) into the intervertebral disc (IVD). One of the main challenges is determining whether an optimal volume of injected cement exists. In this regard, only a limited number of studies have investigated the effect of different cement volumes on spinal stability. This work presents preliminary results from simulations performed using a previously validated finite element model of the lumbar spine (L1–L5), in which the volume of PMMA injected into the L4–L5 disc was varied. Seven models were generated according to the amount of cement occupying the disc space, and the resulting ranges of motion (ROM) were compared with those of both a healthy spine and a fully degenerated spine (without nucleus pulposus). These two loading conditions were considered the most relevant and essential movements during the postoperative period. The preliminary findings aim to contribute to the development of more effective cement discoplasty strategies and to establish criteria for identifying an optimal cement volume.