Carbon fiber-reinforced peek versus titanium implants for the surgical treatment of spinal metastases: Evaluation of local disease control and quality of life.

BACKGROUND

Carbon fiber-reinforced PEEK (CFRP) spinal instrumentation has emerged as a promising alternative in the oncological setting, allowing for superior postoperative imaging and radiotherapy planning.We aimed to evaluate the survival, local disease control and quality of life in a population of patients with spinal metastases surgically treated with CFRP or titanium implants.

METHODS

We conducted an observational single-center study on a cohort of 160 patients with vertebral metastases surgically treated from August 2018 to October 2022.Demographic, clinical and surgical data, adverse events and patient-reported outcomes (PROMs) were collected.

RESULTS

129 patients were treated with titanium and 31 patients with CFRP instrumentation. The median survival time of the entire population was 24.3 months, with no statistically significant difference between the two groups (p = 0.637). Local disease progression was recorded in 36 patients: 27 patients with titanium (20.9%) and 9 patients with CFRP (29.0%). The type of instrumentation had no significant impact on the local progression (p = 0.577).After surgery, 61.9% of patients underwent adjuvant systemic therapy and 31.9% of patients underwent radiotherapy at the index spinal lesion: Cox regression models showed the significant protective effect of adjuvant systemic therapy on mortality and also the protective effect of adjuvant radiotherapy, performed within the first year after surgery, on the risk of local recurrence, while no effect was associated with the type of instrumentation.No statistically significant differences emerged between the two groups of patients regarding mechanical complications and quality of life during the follow- up.

CONCLUSION

According to our results, CFRP implants did not confer a statistically significant improvement in survival or local disease control compared with titanium implants.