Motion attenuation surgery in the degenerative lumbar spine: Is cement discoplasty a safe and effective option?

Cement discoplasty (CD) was initially described in 2015. This novel treatment involves injecting polymethylmethacrylate (PMMA) into the degenerate disc cavity. This is particularly applicable to elderly patients with disc degeneration and collapse, where restoration of disc height improves lordosis and sagittal balance, treating symptoms of degenerative scoliosis, foraminal stenosis, adjacent segment degeneration, or flatback syndrome, who would otherwise have significant risks for major spine surgery. In all cases, symptoms are associated with intradiscal vacuum phenomenon (IDVP), a radiological finding associated with advanced disc degeneration. The technique is neither a motion preserving nor fusion procedure. While cement acts best in compression, the concept of stabilising but not fusing the spine in such cases lacks certainty and clarity as to its clinical effectiveness. This narrative review discusses the concepts of this technique, 12 clinical series and four metanalyses, mostly advocating for its use, particularly where it delivers a solution with an acceptable safety profile, short length of stay and short recovery time.