Alvarez-Breckenridge Christopher, de Almeida Romulo, Haider Ali, Muir Matthew, Bird Justin, North Robert, Rhines Laurence, Tatsui Claudio
Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Orthopedic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Neurospine. 2023 Mar;20(1):317-326. doi: 10.14245/ns.2244920.460. Epub 2023 Mar 31.
Carbon-fiber reinforced polyetheretherketone (CFRP)-based spinal implants are an alternative to titanium, offering less image artifact as their metallic counterparts while maintaining similar biomechanical and biocompatibility properties. Its use in the management of spinal tumors has been reported, however the perceived advantages related to improved imaging quality, radiation treatment planning, and detection of tumor recurrence have not been fully assessed.
We performed a retrospective review of medical records amongst oncologic patients treated at MD Anderson Cancer Center with CFRP implants. Histology, tumor location, construct features, time of follow-up, adjuvant radiation, recurrences, overall survival, and hardware-related complications were recorded.
Sixty-nine consecutive patients were assessed (22 primary tumors, 47 metastases) and the median time for follow-up was 5.4 months. Amongst the cohort, a total of 491 CFRP pedicle screws were implanted. Hardware complications were observed in 5 cases (7.04%). Adjuvant radiation was completed in 8 patients with primary tumors and 29 patients with spinal metastases. A total of 28 patients (40.5%) from the combined primary and metastatic cohorts experienced systemic disease progression, with 12 patients (17.3%) demonstrating local recurrences. Amongst primary and metastatic tumors, overall survival (p = 0.363) and rate of local recurrence (p = 0.112) were similar.
This largest series of CFRP implants demonstrates safe and effective spinal stabilization for patients with both primary and metastatic tumors. Enhanced postoperative imaging led to minimal imaging artifacts which facilitated postoperative radiation planning and the ability to detect local recurrence.
基于碳纤维增强聚醚醚酮（CFRP）的脊柱植入物是钛植入物的一种替代选择，与金属植入物相比，其图像伪影较少，同时保持相似的生物力学和生物相容性特性。已有报道其在脊柱肿瘤治疗中的应用，然而，与改善成像质量、放射治疗计划制定以及肿瘤复发检测相关的潜在优势尚未得到充分评估。
我们对在MD安德森癌症中心接受CFRP植入物治疗的肿瘤患者的病历进行了回顾性研究。记录组织学、肿瘤位置、植入物特征、随访时间、辅助放疗、复发情况、总生存期以及与植入物相关的并发症。
连续评估了69例患者（22例原发性肿瘤，47例转移瘤），中位随访时间为5.4个月。在该队列中，共植入了491枚CFRP椎弓根螺钉。观察到5例（7.04%）植入物相关并发症。8例原发性肿瘤患者和29例脊柱转移瘤患者完成了辅助放疗。原发性和转移瘤合并队列中共有28例患者（40.5%）出现全身疾病进展，12例患者（17.3%）出现局部复发。在原发性和转移性肿瘤中，总生存期（p = 0.363）和局部复发率（p = 0.112）相似。
这一最大规模的CFRP植入物系列研究表明，对于原发性和转移性肿瘤患者，CFRP植入物可实现安全有效的脊柱稳定。术后成像增强导致图像伪影最小，这有助于术后放疗计划制定以及检测局部复发。
