Carbon-fiber reinforced PEEK instrumentation for spondylodiscitis: a single center experience on safety and efficacy

Abstract Radiolucent carbon-fiber-reinforced (CFR) polyethyl-ether-ether-ketone (PEEK) has been established in spinal instrumentation for oncological reasons. Laboratory data reported comparable bacterial adhesion as titanium. Thus, using of CFR-PEEK spinal instrumentation for spondylodiscitis bases...

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Autores principales:	Ann-Kathrin Joerger, Ehab Shiban, Sandro M. Krieg, Bernhard Meyer
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f37cb68fbda748beb73c9ebb9ed7a89e
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spelling	oai:doaj.org-article:f37cb68fbda748beb73c9ebb9ed7a89e2021-12-02T14:16:34ZCarbon-fiber reinforced PEEK instrumentation for spondylodiscitis: a single center experience on safety and efficacy10.1038/s41598-021-81960-82045-2322https://doaj.org/article/f37cb68fbda748beb73c9ebb9ed7a89e2021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81960-8https://doaj.org/toc/2045-2322Abstract Radiolucent carbon-fiber-reinforced (CFR) polyethyl-ether-ether-ketone (PEEK) has been established in spinal instrumentation for oncological reasons. Laboratory data reported comparable bacterial adhesion as titanium. Thus, using of CFR-PEEK spinal instrumentation for spondylodiscitis bases on artifact-free imaging to evaluate therapeutic success. Studies comparing the rate of pedicle screw loosening and relapse of spondylodiscitis following titanium versus CFR-PEEK instrumentation do not exist so far. This study evaluates the rate of pedicle screw loosening and recurrence of spondylodiscitis after CFR-PEEK instrumentation for spondylodiscitis compared to titanium. We conducted a prospective single center study between June 2018 and March 2019 on consecutive 23 patients with thoracolumbar spondylodiscitis. Imaging data was evaluated for screw loosening at a minimum of three months after surgery. A matched-pair analysis was performed using spondylodiscitis cases between 2014 and 2016 using titanium instrumentation for equal localization, surgery, and microorganism class. Among 17 cases with follow-up imaging, six cases (35%) showed screw loosening while only 14% (two patients) with titanium instrumentation were loosened (p = 0.004). In both groups the most frequent bacterium was Staphylococcus aureus, followed by Staphylococcus epidermidis. From the S. aureus cases, one infection in both groups was caused by methicillin resistant species (MRSA). No difference was found in the rate of 360° fusion in either group due to matching criteria. As opposed to other indications CFR-PEEK screws show more loosening than titanium in this series with two potentially underlying reasons: a probably stronger bacterial adhesion on CFR-PEEK in vivo as shown by a statistical trend in vitro and instrumentation of spondylytic vertebrae. Until these factors are validated, we advise caution when implanting CFR-PEEK screws in infectious cases.Ann-Kathrin JoergerEhab ShibanSandro M. KriegBernhard MeyerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ann-Kathrin Joerger Ehab Shiban Sandro M. Krieg Bernhard Meyer Carbon-fiber reinforced PEEK instrumentation for spondylodiscitis: a single center experience on safety and efficacy
description	Abstract Radiolucent carbon-fiber-reinforced (CFR) polyethyl-ether-ether-ketone (PEEK) has been established in spinal instrumentation for oncological reasons. Laboratory data reported comparable bacterial adhesion as titanium. Thus, using of CFR-PEEK spinal instrumentation for spondylodiscitis bases on artifact-free imaging to evaluate therapeutic success. Studies comparing the rate of pedicle screw loosening and relapse of spondylodiscitis following titanium versus CFR-PEEK instrumentation do not exist so far. This study evaluates the rate of pedicle screw loosening and recurrence of spondylodiscitis after CFR-PEEK instrumentation for spondylodiscitis compared to titanium. We conducted a prospective single center study between June 2018 and March 2019 on consecutive 23 patients with thoracolumbar spondylodiscitis. Imaging data was evaluated for screw loosening at a minimum of three months after surgery. A matched-pair analysis was performed using spondylodiscitis cases between 2014 and 2016 using titanium instrumentation for equal localization, surgery, and microorganism class. Among 17 cases with follow-up imaging, six cases (35%) showed screw loosening while only 14% (two patients) with titanium instrumentation were loosened (p = 0.004). In both groups the most frequent bacterium was Staphylococcus aureus, followed by Staphylococcus epidermidis. From the S. aureus cases, one infection in both groups was caused by methicillin resistant species (MRSA). No difference was found in the rate of 360° fusion in either group due to matching criteria. As opposed to other indications CFR-PEEK screws show more loosening than titanium in this series with two potentially underlying reasons: a probably stronger bacterial adhesion on CFR-PEEK in vivo as shown by a statistical trend in vitro and instrumentation of spondylytic vertebrae. Until these factors are validated, we advise caution when implanting CFR-PEEK screws in infectious cases.
format	article
author	Ann-Kathrin Joerger Ehab Shiban Sandro M. Krieg Bernhard Meyer
author_facet	Ann-Kathrin Joerger Ehab Shiban Sandro M. Krieg Bernhard Meyer
author_sort	Ann-Kathrin Joerger
title	Carbon-fiber reinforced PEEK instrumentation for spondylodiscitis: a single center experience on safety and efficacy
title_short	Carbon-fiber reinforced PEEK instrumentation for spondylodiscitis: a single center experience on safety and efficacy
title_full	Carbon-fiber reinforced PEEK instrumentation for spondylodiscitis: a single center experience on safety and efficacy
title_fullStr	Carbon-fiber reinforced PEEK instrumentation for spondylodiscitis: a single center experience on safety and efficacy
title_full_unstemmed	Carbon-fiber reinforced PEEK instrumentation for spondylodiscitis: a single center experience on safety and efficacy
title_sort	carbon-fiber reinforced peek instrumentation for spondylodiscitis: a single center experience on safety and efficacy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/f37cb68fbda748beb73c9ebb9ed7a89e
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Carbon-fiber reinforced PEEK instrumentation for spondylodiscitis: a single center experience on safety and efficacy

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