Moon Seung-Myung, Ingalhalikar Aditya, Highsmith Jason M, Vaccaro Alexander R
Department of Neurosurgery, Hangang Sacred Heart Hospital, Hallym University, Yeongdeungpo-dong, Seoul, South Korea.
Spine J. 2009 Apr;9(4):330-5. doi: 10.1016/j.spinee.2008.11.012. Epub 2009 Jan 6.
Polyetheretherketone (PEEK) is gaining favor as a spinal implant material for interbody and corpectomy cages as well as stabilizing rods. However, there has been little correlation to a relevant and reproducible clinical model. Biomechanical data on PEEK rod constructs have not been reported.
To quantify the stabilizing effects of PEEK versus titanium (Ti) instrumentation in a thoracolumbar corpectomy model.
Corpectomy and randomized instrumentation with an all-Ti, all-PEEK, and hybrid cage/rod construct were performed on cadaveric spines to assess biomechanical differences.
Pure unconstrained bending moments were applied to the intact spine and subsequent test constructs in the three physiologic planes using a load control protocol. Motion tracking and analysis were carried out to quantify and compare the range of motion (ROM) between different test constructs in each plane.
Flexion ROM did not show significant changes compared with intact, whereas the all-Ti and hybrid construct reduced ROM significantly in extension. Lateral bending was significantly reduced in all the treatment groups. Rotational stability of the construct was significantly compromised by an all-PEEK spinal construct.
The rigidity of the corpectomy construct increased as the amount of Ti in the construct increased. A hybrid construct incorporating a PEEK corpectomy cage and Ti rods may provide adequate stability for an anterior thoracolumbar reconstruction in the sagittal and coronal planes. An all-PEEK construct may provide adequate stability in the coronal and sagittal planes but may compromise the stability significantly in axial rotation. Consideration should be given for supplemental posterior instrumentation if an all-PEEK construct is used in an anterior thoracolumbar spinal reconstruction procedure.
聚醚醚酮（PEEK）作为椎间融合器和椎体切除融合器以及固定棒的脊柱植入材料越来越受到青睐。然而，与相关且可重复的临床模型之间的相关性很小。关于PEEK棒结构的生物力学数据尚未见报道。
在胸腰椎椎体切除模型中量化PEEK与钛（Ti）器械固定的稳定效果。
对尸体脊柱进行椎体切除，并采用全钛、全PEEK以及混合笼/棒结构进行随机器械固定，以评估生物力学差异。
使用载荷控制方案，在三个生理平面上对完整脊柱及后续测试结构施加纯无约束弯矩。进行运动跟踪和分析，以量化和比较各平面不同测试结构之间的活动范围（ROM）。
与完整脊柱相比，前屈ROM无显著变化，而全钛和混合结构在伸展时显著降低了ROM。所有治疗组的侧方弯曲均显著降低。全PEEK脊柱结构显著损害了结构的旋转稳定性。
椎体切除结构的刚度随着结构中钛含量的增加而增加。包含PEEK椎体切除融合器和钛棒的混合结构可为胸腰椎前路重建在矢状面和冠状面提供足够的稳定性。全PEEK结构在冠状面和矢状面可能提供足够的稳定性，但在轴向旋转时可能会显著损害稳定性。如果在胸腰椎前路脊柱重建手术中使用全PEEK结构，应考虑补充后路器械固定。
