Resident UNC Chapel Hill, Neurosurgery Chapel Hill, North Carolina, United States
Introduction: The management of spinal oncology necessitates a multi-modal approach, with surgical intervention, radiation-based therapy, and post-operative advanced imaging. These systems must work well together to provide optimal patient outcomes. Traditional metallic spinal implants produce image artifacts and lead to radiation dose attenuation, which inhibit both disease monitoring and disease treatment, respectively. In this retrospective review, we demonstrate the feasibility of an improved biomaterial implant that provides structural stability, while also allowing for disease monitoring and treatment in spinal oncology patients.
Methods: From February 2021 to September 2021, three patients with spinal oncologic deformity requiring resection and posterior spinal stabilization underwent fixation with polyether ether ketone-carbon fiber implants at a single academic institution. All patients had full neurologic preoperative examinations, radiographic studies, and at least three months of clinic follow-up with post-operative advanced imaging studies.
Results: Patient ages ranged from 23 to 74 (mean: 44.7 years). All patients underwent posterior spinal fixation using standard approaches. They each received polyether ether ketone-carbon fiber pedicle screw and rod implants, placed in standard fashion. There were no dural tears, postoperative wound infections, or other complications related to their treatment. Postoperative surveillance revealed gross total resection of the targeted tumors on radiographic imaging. Further, postoperative imaging demonstrated minimal hardware artifact, which was useful in optimizing adjuvant stereotactic radiosurgery as well as visualizing tumor recurrence on follow up imaging.
Conclusion : Polyether ether ketone-carbon fiber implants are a safe and effective option for the treatment of thoracolumbar posterior spinal pathology. They allow for biomechanical stabilization without significant metal artifact on advanced radiographic studies, which improves planning and administration of stereotactic radiosurgery as well as tumor surveillance. The utilization of this novel type of instrumentation in posterior spinal approaches may provide benefit to patients with spinal tumors over existing forms of posterior spinal instrumentation.
