Biomechanical evaluation and comparison of polyetheretherketone rod system to traditional titanium rod fixation on adjacent levels

Chang, Ting‐Kuo; Huang, Chang‐Hung; Liu, Yueh-Ching; Chen, Wen-Chuan; McClean, Colin J.; Lai, Yu‐Shu; Cheng, Cheng‐Kung

doi:10.1016/j.fjmd.2013.04.003

Cited by 15 publications

(6 citation statements)

References 18 publications

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“…It has been concluded that compared to titanium rod, PEEK and carbon-fiber-reinforced (CFR)-PEEK rods provide more flexibility to the lumbar spine and reduce the probability of breakage of the pedicle screw. 7 Chang et al 6 compared the PEEK and titanium rod and concluded that the PEEK rod is better compared to titanium rod.…”

Section: Discussionmentioning

confidence: 99%

“…Polymer-based semi-rigid rods like polyether-ether-ketone (PEEK) and ultra high molecular weight poly ethylene (UHMWPE) reduce the fusion rate and improve the clinical results for pedicle screw fixation. [6][7][8] Recently, the concept of dynamic stabilization has become popular for the treatment of slight DDD. 9 Several non-fusion implants are offered for dealing of slight degenerate disc disease as 'flexible' or 'dynamic' fixation.…”

Section: Introductionmentioning

confidence: 99%

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A comparison of rigid, semi-rigid and flexible spinal stabilization devices: A finite element study

Biswas

Roy

Rana

et al. 2019

Proc Inst Mech Eng H

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Pedicle-screw-based spinal fixation system has shown its success for treating degenerative disc disease-related back pain and spinal instability. In the last few decades, several non-fusion implants ( ‘flexible’ or ‘dynamic’ fixation) are developed for treating slight degenerate disc disease. The aim of this study is to characterize and compare the biomechanical responses of pedicle-screw-based fusion with various rod materials and a flexible spinal stabilization device on the lumbar spine (L3L5). Computed tomography scan-based finite element model and pedicle screw fixation with rigid rod material stainless steel rod, semi-rigid rod material poly-ether-ether-ketone and flexible rod device made of stainless steel are used in this study. Intact model of the lumbar spine and treated with all the different implants are simulated under typical physiological loading conditions. Compared with the intact model, pedicle screw with the stainless steel rod fixation system is found to offer very less range of motion. Poly-ether-ether-ketone rod system increased range of motion 3.8, 7 and 1.8 times for axial rotation, lateral bending and flexion–extension, respectively, compared to the stainless steel rod system. The flexible rod device rod system is found to reduce stress on vertebral body, carrying out more loads as compared to poly-ether-ether-ketone rods. In the case of stainless steel rods, range of motion is almost restricted on the fusion zone, which is overcome by the poly-ether-ether-ketone rod system to some extent and farther improved by the flexible rod device rod system. So, the poly-ether-ether-ketone rod and flexible rod device rod systems may be implemented for better clinical results after succeeding experimental validation and clinical trial.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A comparison of rigid, semi-rigid and flexible spinal stabilization devices: A finite element study

Biswas

Roy

Rana

et al. 2019

Proc Inst Mech Eng H

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“…14 Intradiscal pressures at adjacent segments were highest with dynamic devices, intermediate with semirigid rods, and lowest with rigid constructs; however, stress values at adjacent segments were lower in PEEK than titanium constructs in any direction of motion. 15,16…”

Section: Discussionmentioning

confidence: 99%

Lumbar Fusion With Polyetheretherketone Rods Use for Patients With Degenerative Disease

Ross¹,

Ross²

2021

Federal Practitioner

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Polyetheretherketone (PEEK) rods for lumbar fusion have been available since 2007. However, literature about their utility is sparse and of mixed outcomes. Methods: A retrospective review of PEEK rod lumbar fusion cases was performed. Data were analyzed from 108 patients of the senior author Donald Ross who underwent PEEK lumbar fusion. Results: There were 97 single and 11 2-level fusions. Rates of tobacco use, diabetes mellitus, low bone density, depression, and immunosuppression were 23.1%, 24.1%, 14.8%, 32.4%, and 6.5%, respectively. In the study population, the mean age was 60.2 years, body mass index was 30.1, and there was a mean 31.3 months for follow-up. There were no wound infections or new neurologic deficits. Of 81 patients with > 11 months of follow-up, 70 (86.4%) had an arthrodesis, 8 (9.9%) had no ar-throdesis, and 3 (3.7%) were indeterminate. No patients had revision fusion surgery and 2 patients had adjacent level fusions at 27 and 60 months. One patient had an adjacent segment laminectomy at 18 months and one a foraminotomy at 89 months, resulting in a 3.7% adjacent segment surgery rate. Mean preoperative Short Form-36 (SF-36) physical functioning (PF) score and Oswestry Disability Index (ODI) score were 28.9 and 24.8, respectively. Mean SF-36 PF postoperative score at 1 and 2 years were 59.3 and 65, respectively. Mean ODI postoperative score at 1 year was 14.5. Conclusions:In a large patient cohort lumbar fusion with PEEK rods can be undertaken with low complication rates, satisfactory clinical improvements, low rates of hardware failure or need for revision surgery. Longer follow-up is needed to confirm findings.

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“…As analyzed from the results, the change in biomechanical characteristics of SRSDbased model lies in between DS and RI-based models. However, there are other factors such as change of material, 26,30,31 implant architecture, 19 stiffness, 6,19 which may influence the biomechanical aspects and this may also require further clinical studies.…”

Section: Discussionmentioning

confidence: 99%

Prediction of biomechanical behavior of lumbar vertebrae using a novel semi-rigid stabilization device

Jain

Khan

2019

Proc Inst Mech Eng H

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The work investigates the effect of proposed novel semi-rigid stabilization device on lumbar segment L2-L3 so as to preserve motion at vertebral level. Here, the biomechanical behavior of intact spine with three instrumented spinal models (semi-rigid stabilization device, rigid implant and dynamic stabilization system NFlex) have been compared under the motion conditions of flexion, extension, bending and twist. Three-dimensional non-linear finite models of intact spine, semi-rigid stabilization device, rigid implant and dynamic stabilization system NFlex were developed in the present study. All the four models were subjected to a combined load of 400 N in axial compression along with 2, 4, 6, 8 and 10 N m as bending moment individually. Dynamic stabilization system NFlex shows the maximum variation in motion and reflects range of motion as 89.7% during lateral bending, 53.4% in flexion, 34.6% in twist and 28.0% in extension with respect to intact spine. However, semi-rigid stabilization device and rigid implant shows the range of motion of 60%, 48.7%, 32% and 21.8% and 60%, 32.3%, 22.3% and 21.7% of intact, respectively, during bending, flexion, twist and extension. Finite element simulation results reveal that semi-rigid stabilization device shows comparatively lower values than dynamic stabilization system NFlex and higher as compared to rigid implant for measured intradiscal pressure and von Mises strain at intervertebral disc-23.

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Biomechanical evaluation and comparison of polyetheretherketone rod system to traditional titanium rod fixation on adjacent levels

Cited by 15 publications

References 18 publications

A comparison of rigid, semi-rigid and flexible spinal stabilization devices: A finite element study

A comparison of rigid, semi-rigid and flexible spinal stabilization devices: A finite element study

Lumbar Fusion With Polyetheretherketone Rods Use for Patients With Degenerative Disease

Prediction of biomechanical behavior of lumbar vertebrae using a novel semi-rigid stabilization device

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