Mariscal Gonzalo, Vyas Praveer S, Cheng Boyle C, Arts Jacobus J, Hoelen Thomay-Claire A, Xu Chen, Chaput Christopher D
Institute for Research on Musculoskeletal Disorders, Valencia Catholic University, Valencia, Spain.
Orthopaedic Institute, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA, USA.
Global Spine J. 2025 Jun 3:21925682251336716. doi: 10.1177/21925682251336716.
Study DesignSystematic review and meta-analysis.ObjectiveA systematic review and meta-analysis of comparative studies was performed to compare the fusion rates, functional outcomes, and complications between Titanium-Coated Polyetheretherketone (TiPEEK) and polyetheretherketone (PEEK) cages.MethodsFour databases were systematically searched according to PRISMA. Adult patients who underwent one- or two-level lumbar fusion with TiPEEK or PEEK cages were included in the study. Studies that reported radiographic fusion and functional or complication outcomes were also included. Study quality was assessed using the Cochrane Risk of Bias tool and MINORS criteria. The meta-analysis was performed using Review Manager 5.4. Heterogeneity was assessed using I, and random effects were used to analyze the heterogeneity.Results8 studies (n = 670) were analyzed. TiPEEK showed a significantly higher overall fusion rate (OR 1.83, 95% CI: 1.18-2.83). TiPEEK cages presented significantly higher fusion rates at 6 months (OR 2.52, 95% CI: 1.11 to 5.72), but there were no significant differences at 12 months (OR 1.33, 95% CI: 0.65 to 2.73). No differences were observed in the global ODI (SMD -0.04, 95% CI: -0.15-0.06). There were no significant differences regarding overall subsidence (OR 0.72, 95% CI: 0.48 to 1.07), screw complications (OR 1.25, 95% CI: 0.30-5.27) or reoperations (OR 0.61, 95% CI: 0.11-3.37).ConclusionsThe results from this study suggest that TiPEEK cages may demonstrate earlier fusion as compared to PEEK cages, particularly at 6 months. However, the functional outcomes and safety profiles were comparable.
系统评价与荟萃分析。
对比较研究进行系统评价和荟萃分析，以比较钛涂层聚醚醚酮（TiPEEK）与聚醚醚酮（PEEK）椎间融合器的融合率、功能结局及并发症。
根据PRISMA系统检索四个数据库。纳入接受单节段或双节段腰椎融合术并使用TiPEEK或PEEK椎间融合器的成年患者。纳入报告影像学融合及功能或并发症结局的研究。使用Cochrane偏倚风险工具和MINORS标准评估研究质量。使用Review Manager 5.4进行荟萃分析。使用I²评估异质性，并采用随机效应模型分析异质性。
分析了8项研究（n = 670）。TiPEEK的总体融合率显著更高（OR 1.83，95%CI：1.18 - 2.83）。TiPEEK椎间融合器在6个月时融合率显著更高（OR 2.52，95%CI：1.11至5.72），但在12个月时无显著差异（OR 1.33，95%CI：0.65至2.73）。全球功能障碍指数（ODI）无差异（标准化均数差 -0.04，95%CI：-0.15 - 0.06）。总体下沉、螺钉并发症或再次手术方面无显著差异（OR 0.72，95%CI：0.48至1.07；OR 1.25，95%CI：0.30 - 5.27；OR 0.61，95%CI：0.11 - 3.37）。
本研究结果表明，与PEEK椎间融合器相比，TiPEEK椎间融合器可能融合更早，尤其是在6个月时。然而，功能结局和安全性相当。
