Antibiotic-impregnated polymethylmethacrylate as an anterior biomechanical device for the treatment of cervical discitis and vertebral osteomyelitis: Technical report of two cases

Abstract

Aim: To evaluate the feasibility of this novel surgical approach for treatment of cervical discitis and vertebral osteomyelitis. Material and Methods: This is a report of two patients who underwent anterior cervical decompression for discitis and vertebral osteomyelitis (DVO) with cervical spine reconstruction with polymethylmethacrylate impregnated with antibiotics (AI-PMMA). Results: Both patients had successful procedures that were followed by 6 weeks of intravenous antibiotics. Stabilization and eradication of infection was achieved with clinical and radiographic stabilization seen in both. Follow-up is greater than 18 months and both patients remain off antibiotics. Conclusion: The described technique using AI-PMMA offers immediate structural stability and local delivery of high concentration of antibiotics. Use in two patients has demonstrated a cost effective, long-term biomechanically stable construct and infection control.