Can Polyether Ether Ketone Dethrone Titanium as the Choice Implant Material for Metastatic Spine Tumor Surgery?

Kumar, Naresh; Ramakrishnan, Sridharan Alathur; Lopez, Keith Gerard; Madhu, Sirisha; Ramos, Miguel Rafael David; Fuh, Jerry Ying Hsi; Hallinan, James Thomas Patrick Decourcy; Nolan, Colum Patrick; Benneker, Lorin Michael; Vellayappan, Balamurugan

doi:10.1016/j.wneu.2021.01.059

Cited by 24 publications

(9 citation statements)

References 104 publications

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“…The elastic modulus of PEEK (approximately 3.6 GPa) is smaller than that of cortical bone (17–21 GPa), and carbon fiber can be added into PEEK to make its elastic modulus closer to that of cortical bone. 52 This property allows optimal loading of the bone and prevents stress shielding. Moreover, with good chemical resistance, 53 PEEK can resist the body's natural oxidative environment, thus minimizing the chance of local tissue reactions.…”

Section: Peekmentioning

confidence: 99%

“…The first application of PEEK as spinal implant was as an intervertebral cage, which overcame two problems of traditional metal intervertebral cages: high elastic modulus and stress shielding. The elastic modulus of PEEK (approximately 3.6 GPa) is smaller than that of cortical bone (17–21 GPa), and carbon fiber can be added into PEEK to make its elastic modulus closer to that of cortical bone 52 . This property allows optimal loading of the bone and prevents stress shielding.…”

Section: Peekmentioning

confidence: 99%

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Implant Materials for Anterior Column Reconstruction of Cervical Spine Tumor

Chen

Zhai

Zhou

et al. 2023

Orthopaedic Surgery

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The spine is the most common site of bone metastases. Many cancer patients will ultimately develop spinal metastatic disease with symptomatic epidural spinal cord compression. At present, the main treatment for cervical spine tumors is surgical resection combined with postoperative radiotherapy. Implant materials for cervical spine anterior column reconstruction need to meet amounts of different properties, such as biocompatibility, bioactivity and the ability to maintain long‐term mechanical strength. The selection of different materials determines the surgical efficacy and prognosis of patients to a certain extent. This article provides an overview of a variety of implant materials used for anterior column reconstruction after cervical spine tumor resection, introduces and analyzes their properties, advantages, disadvantages, derivatives, and applications in clinical practice, and looks forward to the future development of implant materials.

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Section: Peekmentioning

confidence: 99%

Section: Peekmentioning

confidence: 99%

Implant Materials for Anterior Column Reconstruction of Cervical Spine Tumor

Chen

Zhai

Zhou

et al. 2023

Orthopaedic Surgery

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“…In some images, apparent interfacial gaps were seen among the new bone, implant, and original bone, possibly resulting from the fixation, dehydration, resin embedding, and cutting-grinding during sample preparation. 26,27 Kumar et al 28 concluded that CPEEK is more difficult to manipulate (handling, contouring and cutting) than Ti, which may be the reason for the more obvious gaps between implant and bone in CPEEK groups.…”

Section: Sem Observationmentioning

confidence: 99%

Osseointegration behavior of carbon fiber reinforced polyetheretherketone composites modified with amino groups: An in vivo study

Wang

Shi

et al. 2022

J Biomed Mater Res

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Polyetheretherketone (PEEK) has become increasingly popular in dentistry and orthopedics due to its excellent chemical stability, reliable biosafety, and low elastic modulus. However, PEEK's biomechanical strength and bioactivity are limited and need to be increased as an implant material. The previous study in vitro has shown that the amino-functionalized carbon fiber reinforced PEEK (A-30%-CPEEK) possessed enhanced mechanical property and bioactivity. This study aims to evaluate the effect of amino groups modification on the osseointegration behavior of carbon fiber reinforced PEEK (30%-CPEEK) in rabbits. Herein, 30%-CPEEK and A-30%-CPEEK implant discs were implanted in rabbit skulls for 5 weeks, with pure titanium implants serving as a control. The bone-forming ability and osseointegration in vivo were systematically investigated by micro-computed tomography analysis, scanning electron microscope observation, and histological evaluation. Our results showed that all detection parameters were significantly different between the A-30%-CPEEK and 30%-CPEEK groups, favoring those in the A-30%-CPEEK, whose appraisal parameters were equal to or better than pure titanium. Therefore, this study supported the importance of amino groups in facilitating the new bone formation and bone-implant integration, suggesting that A-30%-CPEEK with enhanced osseointegration will be a promising material for dental or orthopedic implants.

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“…The use of carbon fibre reinforced polymer (C-FRP) implants, for example, carbon fibres with reinforced polyetheretherketone (CFR-PEEK) have shown promise in this field (Figure 3a-f). In addition to being radiolucent and nonmagnetizable, these have favourable characteristics suitable for use as an orthopaedic implant including low weight, good mechanical strength and improved load transfer to bone, thereby reducing stress-shielding [37,[39][40][41]. In a 2015 qualitative assessment of metal artifacts in patients with femoral or tibial intramedullary nails, CFR-PEEK implants showed reduced metal-related artifacts on T1-weighted, STIR and contrast-enhanced fat-suppressed T1-weighted imaging compared to titanium implants, with high intraobserver agreement [42].…”

Section: Challenges Of Mri: Metal-related Artifactsmentioning

confidence: 99%

State-of-the-Art Imaging Techniques in Metastatic Spinal Cord Compression

Kuah

Vellayappan

Makmur

et al. 2022

Cancers

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Metastatic Spinal Cord Compression (MSCC) is a debilitating complication in oncology patients. This narrative review discusses the strengths and limitations of various imaging modalities in diagnosing MSCC, the role of imaging in stereotactic body radiotherapy (SBRT) for MSCC treatment, and recent advances in deep learning (DL) tools for MSCC diagnosis. PubMed and Google Scholar databases were searched using targeted keywords. Studies were reviewed in consensus among the co-authors for their suitability before inclusion. MRI is the gold standard of imaging to diagnose MSCC with reported sensitivity and specificity of 93% and 97% respectively. CT Myelogram appears to have comparable sensitivity and specificity to contrast-enhanced MRI. Conventional CT has a lower diagnostic accuracy than MRI in MSCC diagnosis, but is helpful in emergent situations with limited access to MRI. Metal artifact reduction techniques for MRI and CT are continually being researched for patients with spinal implants. Imaging is crucial for SBRT treatment planning and three-dimensional positional verification of the treatment isocentre prior to SBRT delivery. Structural and functional MRI may be helpful in post-treatment surveillance. DL tools may improve detection of vertebral metastasis and reduce time to MSCC diagnosis. This enables earlier institution of definitive therapy for better outcomes.

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Can Polyether Ether Ketone Dethrone Titanium as the Choice Implant Material for Metastatic Spine Tumor Surgery?

Cited by 24 publications

References 104 publications

Implant Materials for Anterior Column Reconstruction of Cervical Spine Tumor

Implant Materials for Anterior Column Reconstruction of Cervical Spine Tumor

Osseointegration behavior of carbon fiber reinforced polyetheretherketone composites modified with amino groups: An in vivo study

State-of-the-Art Imaging Techniques in Metastatic Spinal Cord Compression

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