Perez-Roman Roberto J, Boddu James V, Bashti Malek, Bryant Jean-Paul, Amadasu Efosa, Gyedu Joseph S, Wang Michael Y
Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
World Neurosurg. 2023 May;173:13-22. doi: 10.1016/j.wneu.2023.01.090. Epub 2023 Jan 27.
Metastatic spine tumors affect over 30% of patients who have been diagnosed with cancer. While techniques in surgical intervention have undoubtedly evolved, there are some pitfalls when spinal instrumentation is required for stabilization following tumor resection. However, the use of carbon fiber-reinforced polyetheretherketone (CFR-PEEK) implants has become increasingly popular due to improved radiolucency and positive osteobiologic properties. Here, we present a systematic review describing the use of CFR-PEEK-coated instrumentation in the oncologic population while identifying advantages and potential shortcomings of these devices.
In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review was conducted in March 2022 to identify articles detailing the use of CFR-PEEK implants for spinal instrumentation in patients with primary and secondary spine tumors. The search was performed using the PubMed, Scopus, and Embase databases.
An initial search returned a total of 85 articles among the three databases used. After the exclusion of duplicates and screening of abstracts, 21 full-text articles were examined for eligibility. Eleven articles were excluded due to not fitting our inclusion and exclusion criteria. Ten articles were subsequently eligible for full-text review.
CFR-PEEK possesses a similar safety and efficacy profile to titanium implants but has distinct advantages. It limits artifact, increases early detection of local tumor recurrence, increases radiotherapy dose accuracy, and is associated with low complication rates (9.96%)-making it a promising alternative for the demands unique to the treatment/outcome of spinal oncologic patients.
转移性脊柱肿瘤影响超过30%的癌症确诊患者。虽然手术干预技术无疑已经有所发展，但在肿瘤切除后需要脊柱内固定以实现稳定时仍存在一些陷阱。然而，由于其射线可透性的改善和良好的骨生物学特性，碳纤维增强聚醚醚酮（CFR-PEEK）植入物的使用越来越普遍。在此，我们进行一项系统评价，描述CFR-PEEK涂层内固定器械在肿瘤患者中的应用，同时确定这些器械的优点和潜在缺点。
根据PRISMA（系统评价和Meta分析的首选报告项目）指南，于2022年3月进行了一项系统评价，以确定详细描述CFR-PEEK植入物在原发性和继发性脊柱肿瘤患者脊柱内固定中应用的文章。检索使用了PubMed、Scopus和Embase数据库。
在使用的三个数据库中，初步检索共返回85篇文章。在排除重复项并筛选摘要后，对21篇全文文章进行了资格审查。由于不符合我们的纳入和排除标准，11篇文章被排除。随后有10篇文章符合全文审查的资格。
CFR-PEEK具有与钛植入物相似的安全性和有效性，但具有明显优势。它限制了伪影，提高了局部肿瘤复发的早期检测率，提高了放射治疗剂量的准确性，且并发症发生率较低（9.96%），这使其成为满足脊柱肿瘤患者治疗/预后独特需求的一种有前景的替代选择。
