Lam Fred C, Guru Santosh, AbuReesh Deyaldeen, Hori Yusuke S, Chuang Cynthia, Liu Lianli, Wang Lei, Gu Xuejun, Szalkowski Gregory A, Wang Ziyi, Wohlers Christopher, Tayag Armine, Emrich Sara C, Ustrzynski Louisa, Zygourakis Corinna C, Desai Atman, Hayden Gephart Melanie, Byun John, Pollom Erqi Liu, Rahimy Elham, Soltys Scott, Park David J, Chang Steven D
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA.
Brain Sci. 2025 Feb 14;15(2):199. doi: 10.3390/brainsci15020199.
Current standard of care treatment for patients with spine tumors includes multidisciplinary approaches, including the following: (1) surgical tumor debulking, epidural spinal cord decompression, and spine stabilization techniques; (2) systemic chemo/targeted therapies; (3) radiation therapy; and (4) surveillance imaging for local disease control and recurrence. Titanium pedicle screw and rod fixation have become commonplace in the spine surgeon's armamentarium for the stabilization of the spine following tumor resection and separation surgery. However, the high degree of imaging artifacts seen with titanium implants on postoperative CT and MRI scans can significantly hinder the accurate delineation of vertebral anatomy and adjacent neurovascular structures to allow for the safe and effective planning of downstream radiation therapies and detection of disease recurrence. Carbon fiber-reinforced polyetheretherketone (CFR-PEEK) spine implants have emerged as a promising alternative to titanium due to the lack of artifact signals on CT and MRI, allowing for more accurate and safe postoperative radiation planning. In this article, we review the tenants of the surgical and radiation management of spine tumors and discuss the safety, efficacy, and current limitations of CFR-PEEK spine implants in the multidisciplinary management of spine oncology patients.
目前,脊柱肿瘤患者的标准治疗方案包括多学科方法,如下所示:(1)手术肿瘤减容、硬膜外脊髓减压和脊柱稳定技术;(2)全身化疗/靶向治疗;(3)放射治疗;以及(4)用于局部疾病控制和复发监测的影像学检查。钛椎弓根螺钉和棒固定已成为脊柱外科医生在肿瘤切除和分离手术后稳定脊柱的常用手段。然而,术后CT和MRI扫描中钛植入物产生的高度成像伪影会显著阻碍对椎体解剖结构和相邻神经血管结构的精确描绘,从而影响下游放射治疗的安全有效规划以及疾病复发的检测。由于在CT和MRI上缺乏伪影信号,碳纤维增强聚醚醚酮(CFR-PEEK)脊柱植入物已成为钛的一种有前景的替代品,可实现更准确、安全的术后放射治疗规划。在本文中,我们回顾了脊柱肿瘤手术和放射治疗管理的原则,并讨论了CFR-PEEK脊柱植入物在脊柱肿瘤患者多学科管理中的安全性、有效性和当前局限性。