36. Carbon fiber implants for spinal tumors: outcomes and complications

Abstract

BACKGROUND CONTEXT

Due to advances in the detection and treatment of cancer, life expectancy for cancer patients has increased. There is a shift towards less invasive approaches for metastatic spine disease. Carbon fiber implants provide better postop visualization for radiation therapy planning and for obtaining imaging for surveillance purposes.

PURPOSE

To evaluate the outcomes and complications of using carbon fiber implants for spine stabilization in patients undergoing surgery for spine tumors.

STUDY DESIGN/SETTING

A retrospective case series of spinal tumor patients were managed from 12/2020-12/2024.

PATIENT SAMPLE

A retrospective case series of spinal tumor patients were managed from 12/2020-12/2024.

OUTCOME MEASURES

A total of 30 patients undergoing 31 procedures (14 percutaneous and 17 open) with 159 carbon fiber screws and one carbon fiber corpectomy cage.

METHODS

A retrospective case series of spinal tumor patients were managed from 12/2020 - 12/2024. Inclusion criteria were patients with primary or metastatic spine tumors undergoing carbon fiber instrumentation. Patient demographics (age, sex, race/ethnicity) as well as tumor histology, levels of surgery, type of implants used (open pedicle screw, percutaneous pedicle screws) and hybrid constructs (combination of titanium screws and rods with carbon fiber implants) and number of screws. Intraoperative, postop surgical/implant complications, length of follow-up, and patient survival were collected.

RESULTS

A total of 30 patients undergoing 31 procedures (14 percutaneous and 17 open) with 159 carbon fiber screws and one carbon fiber corpectomy cage met the inclusion criteria. The demographics were: average age 60.2 years (15-83), 12 females, 18 males, 13 Whites, 14 Blacks, and 3 Hispanics. Tumor types were multiple myeloma (4), colon cancer (4), breast (4), lung (4), thyroid (3), prostate (2), pancreatic (2), (1), squamous cell (1), aneurysmal bone cyst (ABC) (2), endometrial (1), hepatocellular (1), esophageal (1) and lymphoma (1). Tumor locations were lumbar (n=14), thoracic (n=13), and sacral (n=3). The average estimated blood loss (EBL) was 530.5 ml (50-2000), with the percutaneous implant group having significantly less blood loss compared to the open group (442.5 ml vs 602.9 ml, p< 0.05). Most patients (N=23) had a carbon fiber-only construct, and 7 had a hybrid construct where carbon fiber rods or cages were combined with titanium implants. There was 1 intraop complication. Postop one patient with carbon fiber-only implants underwent revision surgery within 2 weeks of surgery to reposition a right S1 symptomatic percutaneous screw. Three patients who were treated for sacral tumors developed surgical site infection postop that required incision and drainage. Nine patients had passed away at the latest follow-up, and 21 patients were alive with a follow-up spanning 1 to 32 months (average of 8 months).

CONCLUSIONS

Carbon fiber implants for spinal tumors appear to be equivalent to titanium implants, with one implant-related complication requiring a revision. Multicenter studies are needed to evaluate the long-term effectiveness of these implants and to justify the high cost of these implants.

FDA Device/Drug Status

This abstract does not discuss or include any applicable devices or drugs.