Artikel
CFR-PEEK instrumentation for spondylodiscitis – a single-centre experience
CFR-PEEK Instrumentierung bei Spondylodiszitis – eine monozentrische Studie
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Autoren
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Ann-Kathrin Jörger
- Universität Augsburg, Neurochirurgie, Augsburg, Deutschland
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Ehab Shiban
- Universität Augsburg, Neurochirurgie, Augsburg, Deutschland
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Sandro Krieg
- Universität Augsburg, Neurochirurgie, Augsburg, Deutschland
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Bernhard Meyer
- Technische Universität München, Neurochirurgie, München, Deutschland
| Veröffentlicht: | 26. Juni 2020 |
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Gliederung
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Objective: The advantage carbon-fiber-reinforced (CFR) polyethil-ether-ether-ketone (PEEK) material is its radiolucency. CFR-PEEK has been established in spinal instrumentation for primary bone tumors and metastases. Laboratory data showed that CFR-PEEK shows even reduced bacterial adhesion as titanium does.
Thus, the idea to use CFR-PEEK spinal instrumentation for spondylodiscitis cases was to gain artifact free follow-up imaging, so therapeutic success can be evaluated. This study therefore evaluates the first consecutive series of spondylodiscitis patients who underwent CFR-PEEK instrumentation.
Methods: We conducted a prospective single center study. From June 2018 till March 2019 patients with thoracic or lumbar spondylodiscitis and CFR-PEEK instrumentation were included. Follow-up imaging of at least three months after surgery was evaluated in terms of screw loosening. A matched-pair analysis was then performed using data of spondylodiscitis cases from January 2014 till December 2016 with titanium instrumentation for equal localization, operative strategy and type of germ.
Results: 23 patients with CFR-PEEK and 23 with titanium instrumentation were included. Concerning the CFR-PEEK group, in six cases no follow-up imaging was performed. Of the remaining 17 cases, six cases (35%) showed loosening while only 14% of cases with titanium instrumentation were loosened (p=0.004). There was no difference in the rate of 360° fusion in both groups.
Conclusion: As opposed to other indications like tumors etc., for reasons unknown todate CFR-PEEK screws show a higher rate of screw loosening than titanium screws in spinal infections. Until factors related to this are elaborated, we advice caution when implanting CFR-PEEK screws in infectious cases.
