Management of Spinal Dumbbell Tumors via a Minimally Invasive Posterolateral Approach and Carbon Fiber–Reinforced Polyether Ether Ketone Instrumentation: Technical Note and Surgical Case Series

Radiolucent implants in orthopedic oncology

“…Additionally, two late complications with sacral screw loosening at 9 and 12 months secondary to local recurrence provoking instability of the construct, with both revised with CFR‐PEEK screws. Similarly, 1 intraoperative revision of a pedicle screw and 1 case of late screw loosening were found in studies by Neal et al and Müther et al, respectively 10,11 …”

“…Similarly, 1 intraoperative revision of a pedicle screw and 1 case of late screw loosening were found in studies by Neal et al and Müther et al, respectively. 10,11 The possibility of rare intraoperative hardware complication was further corroborated by Ringel et al, who in a series of 251 CFRP pedicle screw insertions found 1 screw incorrectly positioned in the pedicle. 12 Additionally, in a case of osteoblastic metastatic prostate cancer, CFRP screw implantation failed as the initial screw broke on implantation in the extremely hard bone.…”

“…Borani provided examples of intervention for patients with local recurrence, with the 2 patients (33%) who had recurrence after CFRP posterior cervical fixation treated with radiation and denosumab, respectively 9 . Meanwhile, Müther found no evidence of recurrence in their study, while Shen found 1 case of local recurrence in a patient with L1 chordoma 1 year after initial treatment with en‐bloc resection and reconstruction 11,15 …”

“…The authors also found metallic volume is significantly reduced when comparing hybrid CFRP‐titanium systems to standard titanium systems. Several studies concluded significant advantages where postoperative imaging and radiation planning are necessary and unambiguous visualization of the resection cavity on follow‐up imaging 11–13 …”

Carbon fiber lumbopelvic reconstruction following sacral giant cell tumor resection: illustrative case

“…8 These constructs have been especially useful for the mechanical stabilization of the spine after tumor resection. [5][6][7][9][10][11][12][13] The subsequent interference seen when imaging a patient with a traditional metallic construct is reduced and allows for improved tumor surveillance after the procedure, and a more accurate delivery of radiotherapy when indicated. 7,9,11 The present case report documents the use of a CFRP-based construct for lumbosacral fixation and sacral reconstruction after resection for a locally aggressive sacral giant cell tumor.…”