Current advances and challenges in the use of polymethylmethacrylate (PMMA) bone cements in neurosurgery
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Abstract
Introduction: Cranioplasty is essential for cranial reconstruction after craniectomy, using autologous grafts (gold standard) or synthetic materials. PMMA stands out for its economic feasibility and intraoperative flexibility, despite a high complication rate.
Objective: Provide comprehensive analysis of the evolution of PMMA and its variants, highlighting its advances, challenges and continued need for innovations.
Method: An integrative review of 32 recent studies on PMMA in cranioplasty was conducted, selecting articles from PubMed, MedLine, and ScienceDirect. Included sources comprised original articles, reviews, and computational studies from the last 10 years. The search used descriptors such as "Polymethyl Methacrylate" AND "Cranioplasty."
Result: PMMA is widely used and can be intraoperatively shaped, but it presents a high risk of complications. Alternatives include antibiotic-impregnated PMMA, which reduces infections, and customized 3D implants, which optimize aesthetics and surgical time despite higher costs.
Conclusion: Cranioplasty with PMMA is accessible and versatile but has a high complication rate. Strategies such as antibiotic impregnation and improved techniques help mitigate risks. 3D biomaterials emerge as a promising alternative, though more expensive. The choice should balance cost, safety, and patient needs.
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