AB081. Experience using CFR-PEEK implants in metastatic and primary spine tumour surgery: a single centre retrospective study
Abstract

AB081. Experience using CFR-PEEK implants in metastatic and primary spine tumour surgery: a single centre retrospective study

Gabriel Zihui Leow, Priyambada Kumar, Balamurugan Vellayappan, Leon Seow, Jonathan Jiong Hao Tan, Naresh Kumar

National University Health System, Singapore, Singapore

Correspondence to: Gabriel Zihui Leow, MBBS (Singapore). National University Health System, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. Email: gabriel.leow@mohh.com.sg.

Background: Titanium has been the conventional implant material of choice for fixation in both primary and metastatic spine tumour surgeries (MSTS). However, these implants result in artefact generation during post-operative computed tomography (CT) or magnetic resonance imaging (MRI), resulting in poor planning of radiotherapy (RT) and suboptimal tumour surveillance. Carbon fibre-reinforced polyetheretherketone (CFR-PEEK) implants have gained momentum for instrumentation in MSTS due to their radiolucent properties. This in turn does not sacrifice the biomechanical strength of the implants. In this study, we compared the peri-operative outcomes, post operative imaging artefacts and dosimetricdata of CFR-PEEK implants to titanium implants to asses for potential benefits in post-operative RT planning in patients who underwent MSTS.

Methods: This is a retrospective study involving 42 patients operated for MSTS. Patient-related data including demographics, tumour pathology, intra-operative data, functional outcome, and RT-related data were collected for both groups. All patients were followed-up post-operatively for a minimum of 2 years or until demise, whichever was earlier.

Results: In our study, 20 (47.6%) patients had CFR-PEEK implants, while 22 (52.4%) of patients had titanium implants used for MSTS. Both groups of patients had similar clinical outcomes for pain and overall survival predictability pre-operatively (P>0.05). Mean number of levels instrumented by titanium screws were 6.8±2.93, while for the CFR-PEEK screws were 4.07±1.05. Mean volume of artefact generated during post operative CT was 75.1±43.4 mm3 in titanium group and 13.3±14.2 mm3 in CFR-PEEK group (P=0.005). The mean time taken to contour the artefacts was 17.3±5.84 minutes in the titanium group, while the CFR-PEEK group took 9.60±7.17 minutes (P=0.049).

Conclusions: Our study suggests that carbon fibre reinforced PEEK screws significantly reduce artefact generation and the time taken to contour them during post-operative RT planning, while delivering equivalent clinical and functional outcomes as compared to standard titanium implants.

Keywords: Metastatic spine tumour surgery (MSTS); carbon fibre-reinforced polyetheretherketone (CFR-PEEK); adjuvant radiotherapy

Acknowledgments

We extend our special thanks to our Research Assistant, Mr. Renick Lee, for his dedicated time and effort in critically reviewing our manuscript before submission.

Funding: None.

Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab081/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and approved by the institutional (National Health Group, NHG) review board (approval number: 2022/00231). Because of the retrospective nature of the research, the requirement for informed consent was waived.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Cite this abstract as: Leow GZ, Kumar P, Vellayappan B, Seow L, Tan JJH, Kumar N. AB081. Experience using CFR-PEEK implants in metastatic and primary spine tumour surgery: a single centre retrospective study. Chin Clin Oncol 2024;13(Suppl 1):AB081. doi: 10.21037/cco-24-ab081

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