Titanium versus polyetheretherketone implants for vertebral body replacement in the treatment of 77 thoracolumbar spinal fractures

Abstract

Background:Titanium and polyetheretherketone (PEEK) implants have been used in spinal surgery with low rejection rates. Compared to titanium, PEEK has many advantages, including a density more similar to that of bone, radiolucency, and a lack of artifacts in computed tomography (CT) and magnetic resonance imaging (MRI). In this study, we evaluated the effectiveness of PEEK cages as an alternative to titanium for bone fusion after fractures of the thoracolumbar spine. We also propose a classification to the impaction index.Methods:We evaluated 77 patients with fractures of the thoracic or lumbar spine who were treated by anterior fixation with titanium cages (TeCorp®) in 46 (59.7%) patients or PEEK (Verte-stak®) in 31 (40.3%) patients from 2006 to 2012 (Neurological Hospital of Lyon).Results:The titanium group achieved 100% fusion, and the PEEK group achieved 96.3% fusion. The titanium systems correlated with higher impact stress directed toward the lower and upper plateaus of the fused vertebrae; there were no nonunions for those treated with titanium group. Nevertheless, there was only one in the PEEK group. There was no significant difference in the pain scale outcomes for patients with ±10 degrees of the sagittal angle. Statistically, it is not possible to associate the variation of sagittal alignment or the impaction with symptoms of pain. The complication rate related to the implantation of cages was low.Conclusions:Titanium and PEEK are thus equally effective options for the reconstruction of the anterior column. PEEK is advantageous because its radiolucency facilitates the visualization of bone bridges.

Efficacy of a Novel Vertebral Body Augmentation System in the Treatment of Patients with Symptomatic Vertebral Body Fractures

“…The OsseoFix ® (Alphatec Spine Inc., Carlsbad, CA) consists of an intra-vertebral mesh cage implant that can be introduced with or without PMMA injection [ 24 , 25 ]. The SpineJack (Vexim, SA, Balma, France) showed superiority to KP in restoring vertebral heights in a single-center trial and in a cadaver study [ 8 , 9 , 26 ]. Another VA technique is the KIVA (Benvenue Medical Inc., Santa Clara, CA) system, which uses a flexible implant made of a medical polymer to restore height to the vertebral body and hold the cement [ 27 ].…”

“…More complex implants have also been utilized for simultaneous multi-column stabilization. Over the years, techniques other than VBS have been introduced such as the titanium and polyetheretherketone (PEEK) implants which had previously been used in spinal surgery with low rejection rates [ 9 ].…”

Enhancing Distraction Osteogenesis With Carbon Fiber Reinforced Polyether Ether Ketone Bone Pins and a Three-Dimensional Printed Transfer Device to Permit Artifact-Free Three-Dimensional Magnetic Resonance Imaging

“…Titanium metal alloys are frequently used in surgery because of their relatively low magnetic susceptibility artefact when compared with stainless steel [9][10][12][13][14]. Titanium offers a similar material strength to stainless steel at reduced weight, which combined with its biocompatibility and osseointegration makes it ideally suited to implanted medical devices.…”

“…Polyether ether ketone (PEEK) is increasingly being utilised as an alternative to more traditional screws and implants made from titanium or stainless steel [9]. Reported clinical outcomes are comparable to traditional devices, with the added benefit of minimising imaging artefacts.…”

Biomechanical Study of a Novel, Expandable, Non-Metallic and Radiolucent CF/PEEK Vertebral Body Replacement (VBR)

“…Various biomechanical [1,4,5,6,11,12] and clinical studies [2,3,23,24] have addressed spinal stability after implantation of a metallic VBR, while biomechanical studies evaluating non-metallic VBR are rare. The objective of the present study was to quantitatively analyze the biomechanical data of a new, non-metallic CF/PEEK VBR in combination with a dorsal CF/PEEK screw and rod system, with and without cross connectors.…”