Clinical durability of junction-terminating CFR-PEEK constructs in oncologic spine surgery: a single-center retrospective analysis.

PURPOSE: Operative decision making in spine oncology is often influenced by principles derived from deformity surgery, including extension of constructs across spinal junctional regions to mitigate junctional failure. However, oncologic surgical goals are often palliative, which favors smaller operations and shorter constructs for more rapid recovery. These competing priorities create uncertainty when managing tumors at or near junctional segments. We evaluated outcomes in spine tumor patients with constructs terminating at junctional regions. METHODS: We performed a retrospective analysis of patients with primary or metastatic spine tumors who underwent surgical management with carbon fiber-reinforced polyetheretherketone (CFR-PEEK) instrumentation at a single academic center between 2021 and 2025. Inclusion required constructs terminating within a junctional region. Primary endpoints were radiographic failure and clinically relevant failure. RESULTS: Sixty patients met inclusion criteria. Radiographic failure occurred in nine patients (15%), while clinically relevant failure occurred in three patients (5%). Of the clinically relevant failures, two patients required revision surgery and one was managed with therapeutic bracing. Overall, 95% of patients did not require additional surgical intervention or failure-directed conservative management following index surgery. Of the 40 patients who underwent short segment fusions terminating at a junctional segment, none required revision surgery. CONCLUSION: In patients with spine tumors undergoing CFR-PEEK stabilization terminating at junctional segments, clinically consequential construct failure was uncommon. These findings suggest that, when surgical objectives prioritize palliation, rapid recovery, and timely adjuvant therapy, shorter constructs terminating at junctional regions may represent a viable strategy for select oncologic patients.