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.
