Polyetheretherketone (peek) rods in lumbar spine degenerative disease: mid-term results in a patient series involving radiological and clinical assessment

Abstract

Most important among these are adjacent segment disease (ASD) and pseudoarthrosis (3). Rigid stabilization decreases the range of motion of the spinal column and causes increased stress on the adjacent segments postoperatively. Increased stress on the bone-screw interface also leads to instrumentation problems and pseudoarthrosis (35). Dynamic █ INTRODUCTION S tabilization is sometimes required to relieve the symptoms of degenerative spinal disease. Rigid systems are commonly used to solve these problems. Although the short-term results of these implants have been promising, problems occur at high rates during the long-term follow-up. AIM: To evaluate the satisfaction of patients operated due to degenerative lumbar spinal diseases with dynamic stabilization placing polyetheretherketone (PEEK) rods and to share their radiological and clinical results (mid-term) with visual analogue scale (VAS) and Oswestry disability index (ODI) scores. MATERIAL and METHODS: The preoperative and postoperative low back pain, leg pain VAS and ODI scores of 172 patients who were operated for degenerative spinal diseases, were evaluated. Preoperative and postoperative lumbar lordosis were compared. The patients included to the study were evaluated postoperatively around the 2 nd year with lumbar MRI by means of adjacent segment disease (ASD) and additional problems. RESULTS: A statistically but not radiologically-by means of sagittal profile reconstruction-significant increase in lumbar lordosis angle was achieved. Significant improvement was observed in the comparison of preoperative and postoperative period in the analysis of patients' preoperative low back pain (p<0.0001), and decompression-related leg pain VAS scores (p<0.0001). Significant improvement was also observed in the ODI scores of the patients (p<0.0001). Among 172 patients with dynamic stabilization, there were 10 patients who underwent reoperation (5.8%). CONCLUSION: Although it is statistically significant, it can be seen that the lumbar lordosis can not be corrected at significant degrees radiographically in the operations performed with the PEEK rod. Dynamic stabilization with PEEK rod is insufficient for sagittal correction, but the mid-term results reached satisfactory reoperation rates clinically outcomes. Rate of ASD is quite low in stabilization with PEEK rod.

Hybrid surgery with PEEK rods for lumbar degenerative diseases: a 2-year follow-up study

“…The VAS score and ODI score significantly improved, which is consistent with the results of previous studies [ 19 , 25 , 27 ]. Sarbello et al [ 35 ] considered that the radiolucency of the PEEK rods might affect the perceptions of the patients.…”

“…The postoperative lordosis of the upper adjacent segment was 10.7°, which was increased by 1.4° to retain the LL. Ogrenci et al [ 27 ] reported the mid-term follow-up results of 172 patients treated with PEEK rods. The average LL was 42.5° preoperatively and 44.0° postoperatively.…”

“…Kurtz et al [ 34 ] reported 12 cases of revision surgery, and PEEK rods were retrieved, but none of them were broken. In a mid-term follow-up study reported by Ogrenci et al [ 27 ], rod breakage occurred in 1 of 172 patients. Although PEEK rods are invisible on X-ray images, the contours of the rods are visible on CT images.…”

Comparison of clinical and radiological results of dynamic and rigid instrumentation in degenerative lumbar spinal stenosis

“…observed that in 172 patients who underwent PEEK rod instrumentation during an average 2-year follow-up, fusion rates were similar to those in which titanium rods were used according to the literature, but that ASD and other long-term complications were fewer than those in which titanium rods were used, and physiological lumbar movement was better maintained. [ 1 ] Ozer et al . also argued that in 71 patients who were operated on using various dynamic systems, less ASD was shown in follow-ups of at least 2 years compared with rigid systems; moreover, lumbar lordosis and disc height were maintained at a reasonable level.…”

“…Lumbar spinal stenosis is defined as a clinical syndrome characterized by neurogenic claudication or radicular pain due to the narrowing of the spinal canal or neural foramen and the compression of its neural elements. [ 1 ] The narrowing may be caused by bone hypertrophy, ligament hypertrophy, disc protrusion, spondylolisthesis, or a combination thereof. [ 2 ]…”