gms | German Medical Science

133. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

26.04. - 29.04.2016, Berlin

Article

Send article

Polyetheretherketone cages in patients with spinal metastases undergoing postoperative radiotherapy

Meeting Abstract

Search Medline for

  • Michael Müther - University Medical Center Münster, Dept. of Neurosurgery, Münster, Deutschland
  • Mark Klingenhöfer - University Medical Center Münster, Dept. of Neurosurgery, Münster, Deutschland
  • Johannes Löbbecke - University Medical Center Münster, Dept. of Neurosurgery, Münster, Deutschland
  • Michael Schwake - University Medical Center Münster, Dept. of Neurosurgery, Münster, Deutschland
  • Nils Warneke - University Medical Center Münster, Dept. of Neurosurgery, Münster, Deutschland
  • Juliane Schroeteler - University Medical Center Münster, Dept. of Neurosurgery, Münster, Deutschland
  • Kushtrim Shala - St. Marien Hospital Borken, Dept. of General Surgery, Borken, Deutschland
  • Antonio Santacroce - University Medical Center Düsseldorf, Dept. of Radio-Oncology, Düsseldorf, Deutschland
  • Walter Stummer - University Medical Center Münster, Dept. of Neurosurgery, Münster, Deutschland
  • Hans Theodor Eich - University Medical Center Münster, Dept. of Radio-Oncology, Münster, Deutschland
  • Gabriele Reinartz - University Medical Center Münster, Dept. of Radio-Oncology, Münster, Deutschland
  • Christian Ewelt - University Medical Center Münster, Dept. of Neurosurgery, Münster, Deutschland

Deutsche Gesellschaft für Chirurgie. 133. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 26.-29.04.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16dgch287

doi: 10.3205/16dgch287, urn:nbn:de:0183-16dgch2874

Published: April 21, 2016

© 2016 Müther et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Background: Titanium cages are widely used in the surgical treatment of spinal metastases. In most cases adjuvant radiotherapy is an essential part of treatment. Radiation target volumes are defined from postoperative imaging. However, titanium cages lead to metal-related artifacts in imaging. Large polyetheretherketone (PEEK) cages have recently been introduced to the market as parts of corporectomy systems. PEEK does not cause imaging artifacts and may be superior to titanium cages in terms of more exact radiation planning. Our study evaluates the use of titanium and PEEK cages implanted after corporectomy.

Materials and methods: We retrospectively analyzed all cage implantations performed in our center on patients with metastatic spinal tumors between 2011 and 2015. Cases with PEEK cages were compared to titanium cages as a control group respectively. Survival data was obtained. Strong emphasis was put on the evaluation of radiation therapy concepts. Results were stratified by demographic data, tumor histology, tumor localization, pre- and postoperative Karnofsky Performance Status, oncologic concept and follow up radiographic findings.

Results: So far, fourty patients were included into the analysis comparing twenty cases of PEEK and twenty cases of titanium cage implantations. Tumor localization is 10% lumbar, 40% thoracic and 50% cervical spine. Each group shows similar distributions of demographic and oncologic features. All patients underwent radiotherapy 4-6 weeks post surgery. Radiation planning was significantly more circumscribed concerning target areas in the PEEK cage group. No case of implant failures was observed.

Conclusion: To our best knowledge this is the first study comparing the use of PEEK and titanium after corporectomy in the metastatic spine concerning postoperative radiotherapy. Due to decreased imaging artifacts radiotherapy planing is easier. A more focused radiotherapy means a decrease in target volume and associated side effects. We do feel there is a benefit towards the use of PEEK cages in spinal metastases.