CFR-PEEK Pedicle Screw Instrumentation for Spinal Neoplasms: A Single Center Experience on Safety and Efficacy

Abstract

(1) Background: Surgery for spinal metastases has gained a decisive role in modern oncological treatment. Recently, carbon-fiber-reinforced (CFR) polyethyl-ether-ether-ketone (PEEK) pedicle screw systems were introduced, reducing artifacts on imaging and showing less perturbation effects on photon radiation. Preliminary clinical experience with CFR-PEEK implants for spinal metastases exists. The aim of this monocentric study is to report on the safety and efficacy of CFR-PEEK pedicle screw systems for spinal neoplasms in a large cohort of consecutive patients. (2) Methods: We retrospectively analyzed prospectively the collected data of consecutive patients being operated on from 1 August 2015 to 31 October 2021 using a CFR-PEEK pedicle screw system for posterior stabilization because of spinal metastases or primary bone tumors of the spine. (3) Results: We included 321 patients of a mean age of 65 ± 13 years. On average, 5 ± 2 levels were instrumented. Anterior reconstruction was performed in 121 (37.7%) patients. Intraoperative complications were documented in 30 (9.3%) patients. Revision surgery for postoperative complications was necessary in 55 (17.1%) patients. Implant-related complications, such as intraoperative screw breakage (3.4%) and screw loosening (2.2%), were rare. (4) Conclusions: CFR-PEEK is a safe and efficient alternative to titanium for oncological spinal instrumentation, with low complication and revision rates in routine use and with the advantage of its radiolucency.

Radical Surgical Treatment of Spinal Oligometastatic Disease with Metastatic Spinal Cord Compression–Outcome and Evaluation of Feasibility of Carbon Fibre Reinforced PEEK Instrumentation in Comparison to Standard Titanium Fixation

“…Carbon bre reinforced Polyether ketone (CFR-PEEK) instrumentation on the contrary has shown to have excellent biological characteristics to overcome these limitations and has recently gained popularity in orthopaedic oncological surgery [21]. While case series have already described CFR-PEEK instrumentation in polymetastatic spine disease [19] [22][23] [24] [25][26], larger studies evaluating the feasibility and outcome of CFR-PEEK instrumentation in radical surgical treatment concepts plus SBRT for oligometastatic metastatic spinal cord compression (MSCC) compared to standard titanium instrumentation are still missing in literature so far. We, however, deem this to be very clinically relevant issue for patient management since accurate radiation dose delivery and to permit reliable long-term imaging assessment of local control in radical oncological treatment concepts in oligometastatic disease.…”