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German Congress of Orthopaedics and Traumatology (DKOU 2022)

25. - 28.10.2022, Berlin

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Fusion Assessment in Standalone Lateral Lumbar Interbody Fusion: 3D-printed Titanium versus Polyetheretherketone (PEEK) cages

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  • presenting/speaker Dominik Adl Amini - Centrum für Muskuloskeletale Chirurgie, Charité – Universitätsmedizin Berlin, Berlin, Germany
  • Manuel Moser - Luzerner Kantonsspital, Luzern, Switzerland
  • Lisa Oezel - Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
  • Jennifer Shue - Spine Care Institute, Hospital for Special Surgery, New York City, United States
  • Matthias Pumberger - Centrum für Muskuloskeletale Chirurgie, Charité – Universitätsmedizin Berlin, Berlin, Germany
  • Andrew A. Sama - Spine Care Institute, Hospital for Special Surgery, New York City, United States
  • Frank P. Cammisa - Spine Care Institute, Hospital for Special Surgery, New York City, United States
  • Federico P. Girardi - Spine Care Institute, Hospital for Special Surgery, New York City, United States
  • Alexander P. Hughes - Spine Care Institute, Hospital for Special Surgery, New York City, United States

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2022). Berlin, 25.-28.10.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocAB32-1266

doi: 10.3205/22dkou201, urn:nbn:de:0183-22dkou2017

Published: October 25, 2022

© 2022 Adl Amini 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

Objectives: Compare fusion at two independent timepoints (early and late) between 3D-printed Ti and PEEK cages in patients undergoing standalone lateral lumbar interbody fusion (SA-LLIF). We hypothesized that 3D-printed Ti cages show higher fusion rates at an early timepoint compared to PEEK.

Methods: A retrospective study of patients undergoing SA-LLIF with Ti and PEEK cages between 11/2016 and 01/2020 at a single academic institution was done. Fusion was assessed for each treated level using multiplanar reconstructed computed tomography (CT) scans. Presence of fully bridged interbody trabecular bone or continuous bone centered in the cage was considered as fusion.

Results and conclusion: In total, 91 patients (136 levels) were included in the final analysis, 49 patients (72 levels) in the early group and 42 patients (64 levels) in the late group. CT scans were performed on average 8.2±1.8 months postoperatively for the early group and 18.9±7.7 months for the late group. In the early group, fusion was significantly higher for Ti compared to PEEK cages (95.8% versus 62.5%; p=0.002), whereas in the late group no significant difference was seen (94.7% versus 80.0%; p=0.756).

In SA-LLIF, porous Ti cages showed significantly higher fusion rates at an early timepoint compared to PEEK. However, the difference in fusion rates between Ti and PEEK cages was found not to be significantly different at a later timepoint in another patient group. This might support the assumption that 3D-printed Ti cages with a porous architecture are more osteoconductive compared to PEEK and tend to fuse earlier.