Introduction: Management of metastatic spine disease requires substantial multidisciplinary input to maximize outcomes. Utilization of CFR-PEEK instrumentation is increasing as data supporting its role in early detection of disease recurrence and enhancing radiation planning is reported. However, the available literature is limited to short term follow up single-center experiences with CFR-PEEK instrumentation.
Methods: 132 patients were treated at a single-institution, of which 76 were identified as long-term survivors (“LTS”, defined as survival >1 year) treated with CFR-PEEK instrumentation. Demographic, oncology and surgical characteristics, including SINS location, construct length, rod material, post-operative complications and hardware failure. Descriptive data is reported and compared to a historical titanium cohort from the study institution.
Results: Median follow up for the 76 LTS patients was 18.2 months. These patients had various metastatic malignancies, with poorly differentiated adenocarcinoma, prostate, and renal cell carcinoma, occurring most frequently. Tumors were most often located within the semi-rigid spine (50%) and median construct length spanned four vertebrae. All constructs were CFR-PEEK screws and most included CFR-PEEK rods (n=65) versus titanium rods (n=11). Cement augmentation was utilized in 58% cases. In total, there were three hardware (3.9% of CFR-PEEK patients) related complications: 1 screw fracture, 1 screw loosening, and 1 proximal junctional kyphosis. In comparison, the study institution evaluated 482 patients treated with traditional titanium constructs, of which 24 (5% of titanium patients, p=n.s.) experienced hardware failure.
Conclusion : While several studies have reported the short-term CFR-PEEK instrumentation outcomes with low rates of hardware failure, the long-term follow up data is limited. The presented study demonstrates a low rate of hardware-related failures compared to our historic titanium cohort in a cohort of LTS.