Tullberg T
Department of Orthopaedics, St. Görans Hospital, Stockholm, Sweden.
Spine (Phila Pa 1976). 1998 Aug 15;23(16):1804-6. doi: 10.1097/00007632-199808150-00016.
Case report.
Failure of a carbon fiber implant.
To simplify the procedure of posterior lumbar interbody fusion, a carbon-fiber-reinforced polymer implant has been developed. The implant has ridges to resist retropulsion, struts to support weight, and a hollow area to allow packing of autologous bone graft. So far, no complications have been reported from the use of carbon implant as a fusion aid in spine surgery.
A patient with postoperative infection has been followed with computed tomography images and histologic examination from a reoperation.
An entire nonunion across the width of the disc space and a clearly broken cage was visualized with computed tomography. The spinal canal was explored during a reoperation and the tissue surrounding the dura and nerves were all black. Microscopic examination showed a large quantity of carbon particulate debris. The authors have operated on approximately 100 patients so far and no other carbon cage has broken, to their knowledge.
Carbon cages can break if a nonunion occurs and as a result free carbon particles move out to the spinal canal.