Carbon Fiber-Reinforced Polyetheretherketone Spinal Implants for Treatment of Spinal Tumors : Perceived Advantages and Limitations

Purpose: Carbon-fiber reinforced polyetheretherketone (CFRP)-based spinal implants are an alternative to titanium, offering less image artifact as their metallic counterparts while maintaining similar biomechanical and biocompatibility properties. Its use in the manage-ment of spinal tumors has been reported, however the perceived advantages related to im-proved imaging quality, radiation treatment planning, and detection of tumor recurrence have not been fully assessed. Methods: We performed a retrospective review of medical records amongst oncologic pa-tients treated at MD Anderson Cancer Center with CFRP implants. Histology, tumor loca-tion, construct features, time of follow-up, adjuvant radiation, recurrences, overall surviv-al, and hardware-related complications were recorded. Results: Sixty-nine consecutive patients were assessed (22 primary tumors, 47 metastases) and the median time for follow-up was 5.4 months. Amongst the cohort, a total of 491 CFRP pedicle screws were implanted. Hardware complications were observed in 5 cases (7.04%). Adjuvant radiation was completed in 8 patients with primary tumors and 29 patients with spinal metastases. A total of 28 patients (40. 5%) from the combined primary and metastatic cohorts experienced systemic disease progression, with 12 patients (17. 3%) demonstrating local recurrences. Amongst primary and metastatic tumors, overall survival (p = 0.363) and rate of local recurrence (p = 0.112) were similar. Conclusion: This largest series of CFRP implants demonstrates safe and effective spinal sta-bilization for patients with both primary and metastatic tumors. Enhanced postoperative imaging led to minimal imaging artifacts which facilitated postoperative radiation planning and the ability to detect local recurrence.

Automated summary

This retrospective study evaluated the advantages of carbon-fiber reinforced polyetheretherketone (CFRP) pedicle screws in the management of spinal tumors. The results showed that CFRP pedicle screws provided effective spinal stabilization and improved postoperative imaging, facilitating radiation planning and detection of local recurrence.