Carbon fiber reinforced vs titanium implants for fixation in spinal metastases: A comparative clinical study about safety and effectiveness of the new “carbon-strategy”

Separation surgery for metastatic epidural spinal cord compression: A qualitative review

“…Drakhsandeh et al reported no hardware failure in a retrospective series of 27 patients undergoing posterior instrumentation without fusion, while the more reliable 7-years retrospective experience by Amankulor et al that analyzing 318 patients treated with posterior instrumentation without anterior column reconstruction reported 2.8% of hardware failure incidence, while instrumentation longer than 6 levels and chest wall resection resulted to be the risk factors for failure [87] , [88] , [89] . Cofano et al have recently reported no hardware failure in a retrospective series of patients undergoing posterior carbon fiber / PEEK instrumentation, with a mean follow up of 11 months [77] .…”

“…Free hand or navigated and open or percutaneous techniques could be adopted [75] , [76] . Moreover, considering the known need for subsequent radiation treatment, carbon fiber/polyetheretherketone (PEEK) instrumentation has been considered by other authors, in order to reduce scattering and artifacts related to titanium implants [77] , [78] , [79] , [80] . The second step represents the decompressive phase ( Fig.…”

Neurological outcomes after surgery for spinal metastases in symptomatic patients: Does the type of decompression play a role? A comparison between different strategies in a 10-year experience

“…For transpedicular fixation, titanium or carbon-fiber screws have been used throughout the years. Heterologous bone graft, PEEK cages and Titanium or Carbon fiber plates have been used for anterior fixation and replacement when needed [18] .

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Carbon fiber–reinforced PEEK instrumentation in the spinal oncology population: a retrospective series demonstrating technique, feasibility, and clinical outcomes

“…A limited number of clinical papers have been published describing the safety and noninferiority of CFRP compared with titanium hardware. Cofano et al 11 retrospectively compared the safety and effectiveness of CFRP devices with standard titanium implants in patients with spinal metastases. Thirty-six patients underwent CFRP fixation, while titanium implants were used for 42.…”

“…In the spine, screws, rods, plates, and vertebral body replacement CFRP implants have been described for use in the cervical, thoracic, and lumbar spine segments. 3,5,6,[11][12][13] Authors have previously highlighted the advantages of CFRP over titanium systems, including reduced amounts of imaging artifacts, more facile RT planning, and potentially greater safety and quality of radiotherapy. 3,5,6 However, the number of clinical papers on CFRP remains limited, and to our knowledge no clinical series has described greater than 40 patients stabilized with CFRP instrumentation.…”