Palacos is the brand name of a bone cement frequently used in neurosurgery.

Application

In neurosurgery, Palacos is particularly often used for cranioplasties or vertebral body augmentations.

Chemistry

Palacos is a two-component system. Chemically, Palacos is a polymethylmethacrylate (PMMA). The polymer component additionally contains benzoyl peroxide (BPO) in the powder as an initiator of radical polymerization. The powder also contains a radiopaque agent and optionally an antibiotic and/or dye[^1].

Fabrication

When fabricating Palacos, it is initially in a soft and moldable state and hardens within a few minutes. Thus, it is possible, for example, after a craniotomy, during which the original autologous bone flap is no longer used, to shape a suitable bone flap with Palacos during the operation. During the curing of Palacos, it heats up and subsequently cools down.

Imaging

Palacoplasty in MRI — Visualization of Palacos bone cement on MRI in a T1 and T2 sequence.

Palacoplasty in CT — Axial cranial CT in the bone window of a patient with a frontal palacoplasty after a traumatic impression fracture.

Intraoperative

Palacoplasty in the area of the cranial vault — Intraoperative image of a palacoplasty in the region of the cranial vault