TY - JOUR
T1 - Composite PEEK/carbon fiber rods in the treatment for bone tumors of the cervical spine
T2 - a case series
AU - Boriani, Stefano
AU - Pipola, Valerio
AU - Cecchinato, Riccardo
AU - Ghermandi, Riccardo
AU - Tedesco, Giuseppe
AU - Fiore, Maria Rosaria
AU - Dionisi, Francesco
AU - Gasbarrini, Alessandro
N1 - Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - Introduction: Radiotherapy (RT) is frequently applied as an adjuvant therapy during spinal tumors treatment. Metallic implants can interfere with RT planning and execution, as it is known that metallic implants produce a backscattering effect that can limit RT accuracy and their presence can be associated with unwanted dose increase. PEEK/carbon fiber implants are designed to reduce these problems but their application in the cervical spine is limited, due to the reduced number and types of implants, the screw dimensions and the absence of lateral mass screws. We propose a hybrid system made of carbon rods and screws coupled with subliminal polyester bands with titanium clamps. We designed this hybrid construct to enclose the cervical region in the area of instrumentation without limiting the application of postoperative radiotherapy. Materials and methods: Six patients in which the hybrid hardware was implanted were retrospectively examined. Data on demographics, intraoperative and postoperative events, tumor details and staging and cervical alignment were collected pre- and postoperatively. Results: No intraoperative complications occurred. En bloc resection was performed in two patients, while the remaining four received an intralesional resection. Three out of six patients received postoperative RT, without any alteration in its planning and administration. Discussion and conclusions: Hybrid implants made of composite PEEK/carbon fiber screws and rods and sublaminar bands are a helpful solution for spinal reconstruction in the cervical and cervico-thoracic regions after spine tumor surgery. The implants do not produce artifacts at postoperative images, easing the planning and execution of postoperative radiotherapy.
AB - Introduction: Radiotherapy (RT) is frequently applied as an adjuvant therapy during spinal tumors treatment. Metallic implants can interfere with RT planning and execution, as it is known that metallic implants produce a backscattering effect that can limit RT accuracy and their presence can be associated with unwanted dose increase. PEEK/carbon fiber implants are designed to reduce these problems but their application in the cervical spine is limited, due to the reduced number and types of implants, the screw dimensions and the absence of lateral mass screws. We propose a hybrid system made of carbon rods and screws coupled with subliminal polyester bands with titanium clamps. We designed this hybrid construct to enclose the cervical region in the area of instrumentation without limiting the application of postoperative radiotherapy. Materials and methods: Six patients in which the hybrid hardware was implanted were retrospectively examined. Data on demographics, intraoperative and postoperative events, tumor details and staging and cervical alignment were collected pre- and postoperatively. Results: No intraoperative complications occurred. En bloc resection was performed in two patients, while the remaining four received an intralesional resection. Three out of six patients received postoperative RT, without any alteration in its planning and administration. Discussion and conclusions: Hybrid implants made of composite PEEK/carbon fiber screws and rods and sublaminar bands are a helpful solution for spinal reconstruction in the cervical and cervico-thoracic regions after spine tumor surgery. The implants do not produce artifacts at postoperative images, easing the planning and execution of postoperative radiotherapy.
KW - Carbon fiber implants
KW - Radiotherapy
KW - Spinal reconstruction
KW - Spine tumor
UR - http://www.scopus.com/inward/record.url?scp=85088237626&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85088237626&partnerID=8YFLogxK
U2 - 10.1007/s00586-020-06534-0
DO - 10.1007/s00586-020-06534-0
M3 - Article
AN - SCOPUS:85088237626
VL - 29
SP - 3229
EP - 3236
JO - European Spine Journal
JF - European Spine Journal
SN - 0940-6719
IS - 12
ER -