- •Carbon fiber reinforced (CFR)-PEEK implants have been developed for spinal fixation in oncological disease.
- •CFR-PEEK implants constitute a feasible and effective way to restore stability as standard titanium.
- •Further studies are needed to clarify their potentially enormous oncological advantagess.
In spinal oncology traditional titanium implants could significantly impair evaluation of postoperative imaging because of artifacts, potentially affecting proper planning and execution of radiotherapy and adequate radiological follow-up to rule out progression of the disease. This is why carbon fiber reinforced (CFR)-PEEK implants have been developed for spinal fixation. The advantages of this system include fewer artifacts on imaging, potentially improving the execution and quality of radiotherapy, with also a reduced scattering effect to neighboring tissues.
A comparative clinical and radiological study between new CFR-PEEK and standard titanium implants is described. Data recorded for each case included patient demographics, clinical, radiological and surgical data, intra- and postoperative complications, follow-up information. The goal of this study was to verify the safety and effectiveness of CFR-PEEK devices compared to standard titanium implants.
A total number of 78 patients were reviewed. 36 patients underwent CFR-PEEK fixation, while titanium implants were used for 42 patients. Functional recovery was obtained in both groups and registered at last follow-up in terms of axial pain and neurological status. No significative differences were found between the two groups in terms of post-operative clinical complications and hardware-related complications.
CFR-PEEK implants constitute a feasible and effective way to restore stability in metastatic spine tumors. This study found a non inferior favorable profile in terms of intraoperative and postoperative complications and functional recovery, compared to titanium. Further prospective studies are needed to clarify the potential oncological advantage of their radiolucency.
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- State of the art treatment of spinal metastatic disease.Neurosurgery. 2018; 82: 757-769
- An integrated multidisciplinary algorithm for the management of spinal metastases: an International Spine Oncology Consortium report.Lancet Oncol. 2017; 18: e720-e730
- The targeted therapies era beyond the surgical point of view: what spine surgeons should know before approaching spinal metastases.Cancer Control. 2019; https://doi.org/10.1177/1073274819870549
- Molecular markers and targeted therapeutics in metastatic tumors of the spine: changing the treatment paradigms.Spine (Phila Pa 1976). 2016; 41: S218-S223
- Direct decompressive surgical resection in the treatment of spinal cord compression caused by meta- static cancer: a randomised trial.Lancet. 2005; 366: 643-648
- Composite PEEK/Carbon fiber implants can increase the effectiveness of radiotherapy in the management of spine tumors.J Spine Surg. 2017; 3: 323-329
- Carbon-fiber-reinforced PEEK fixation system in the treatment of spine tumors: a preliminary report.Eur Spine J. 2018; 27: 874-881
- A novel classifcation system for spinal instability in neoplastic disease: an evidence-based approach and expert consensus from the Spine Oncology Study Group.Spine (Phila Pa 1976). 2010; 35: E1221-E1229
- Reliability analysis of the epidural spinal cord compression scale.J Neurosurg Spine. 2010 Sep; 13: 324-328
- The use of spine stereotactic radiosurgery for oligometastatic disease.J Neurosurg Spine. 2016; 25: 239-247
- The impact of histology and delivered dose on local control of spinal metastases treated with stereotactic radiosurgery.Neurosurg Focus. 2017; 42: E6
- Perturbation effects of the carbon fiber-PEEK screws on radiotherapy dose distribution.J Appl Clin Med Phys. 2017; 18: 62-68
- Dosimetric characterization of carbon fiber stabilization devices for post-operative particle therapy.Phys Med. 2017; 44: 18-25
- Use of carbon-fiber-reinforced composite implants in orthopedic surgery.Orthopedics. 2014; 37: 825-830
- Carbon fiber intramedullary nails reduce artifact in postoperative advanced imaging.Skelet Radiol. 2015; 44: 1317-1325
- The CarbofixTM ‘‘piccolo proximal femur nail’’: a new perspective for treating proximal femur lesion. A technique report.J Orthop. 2016; 13: 343-346
- Feasibility of knitted carbon/PEEK composites for orthopedic bone plates.Biomaterials. 2004; 25: 3877-3885
- Pedicle screw anchorage of carbon fiber-reinforced PEEK screws under cyclic loading.Eur Spine J. 2018; : 1775-1784
- Biomechanical study of a novel, expandable, non-metallic and radiolucent CF/PEEK Vertebral Body Replacement (VBR).Materials. 2019; 12: 2732
- Radiolucent carbon fiber-reinforced pedicle screws for treatment of spinal tumors: advantages for radiation planning and follow-up imaging.World Neurosurg. 2017; 105: 294-301
- Transpedicular 3D endoscope-assisted thoracic corpectomy for separation surgery in spinal metastases: feasibility of the technique and preliminary results of a promising experience.Neurosurg Rev. 2019;
- Intraoperative neurophysiological monitoring during spinal surgery: technical review in open and minimally invasive approaches.Neurosurg Rev. 2019; 42: 297-307
- Intraoperative neurophysiological monitoring in spine surgery: a systematic review and meta-analysis.Spine (Phila Pa 1976). 2018; 43: 1154-1160
Published online: March 12, 2020
Accepted: March 8, 2020
Received: January 4, 2020
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