Goff Nicolas K, Ashby Landon S, Jensen Justin N, Muzyka Logan, Koltz Michael T
Department of Neurological Surgery, University of Texas at Austin Dell Medical School, Austin, USA.
Department of Orthopedic Surgery, University of Texas at Austin Dell Medical School, Austin, USA.
Cureus. 2025 May 30;17(5):e85080. doi: 10.7759/cureus.85080. eCollection 2025 May.
Adjacent segment disease (ASD) is a common complication and cause of reoperation following lumbar spinal fusion. Although most commonly performed with titanium or other metal rods, the use of polyetheretherketone (PEEK) rods in spinal fusion has increased. It has been hypothesized that the material properties of PEEK, compared to titanium, allow for less strain on, and therefore less degeneration of, segments adjacent to the fused segments. A systematic search of PubMed and ScienceDirect returned 967 abstracts, of which 13 full-text articles were included in the PEEK rod group and 12 articles were included in the titanium rod group. The two cohorts had similar sex distributions, although the PEEK rod group was significantly younger (61.1 years vs. 62.5 years, p < 0.0001). A meta-analysis using a random effects model with restricted maximum likelihood estimation resulted in an overall incidence rate of 0.026 cases per person-year in the PEEK rod group (95% confidence interval (CI) = 0.010-0.043) and an overall incidence rate of 0.024 cases per person-year in the titanium rod group (95% CI = 0.014-0.033). One-way analysis of variance revealed no significant difference in the incidence rates of ASD between the two groups (p = 0.8422). In conclusion, there is no evidence of any difference in the rate of ASD when performing lumbar fusions with PEEK rods versus titanium rods.
相邻节段疾病（ASD）是腰椎融合术后常见的并发症及再次手术的原因。尽管脊柱融合术最常使用钛棒或其他金属棒，但聚醚醚酮（PEEK）棒在脊柱融合术中的使用有所增加。据推测，与钛相比，PEEK的材料特性使融合节段相邻节段的应变更小，因此退变也更少。对PubMed和ScienceDirect进行系统检索后得到967篇摘要，其中13篇全文文章被纳入PEEK棒组，12篇文章被纳入钛棒组。两组的性别分布相似，尽管PEEK棒组明显更年轻（61.1岁对62.5岁，p<0.0001）。使用限制最大似然估计的随机效应模型进行的荟萃分析得出，PEEK棒组的总体发病率为每人年0.026例（95%置信区间（CI）=0.010-0.043），钛棒组的总体发病率为每人年0.024例（95%CI=0.014-0.033）。单因素方差分析显示两组间ASD的发病率无显著差异（p=0.8422）。总之，没有证据表明使用PEEK棒与钛棒进行腰椎融合时ASD的发生率存在差异。
