Global Spine Journal最新文献

{"title":"Editorial: Precision Medicine in Spinal Oncology.","authors":"Arjun Sahgal, Laurence Rhines","doi":"10.1177/21925682241250342","DOIUrl":"10.1177/21925682241250342","url":null,"abstract":"<p><p>This special focus issue from the 2023-2024 AOSpine Knowledge Forum Tumor represents a culmination of years of experience devoted to advancing the care of patients with both metastatic and primary spinal tumors. We have learned much since the fundamental assessments of instability that led to the Spinal Instability Neoplastic Score (SINS), the grading of epidural disease utilizing the Epidural Spinal Cord Compression Scale (aka Bilsky grade), as well as the development of tumor-specific health related quality of life assessments such as the Spine Oncology Study Group Outcome Questionnaire (SOSGOQ). These tools have enabled us to make several prior recommendations for the appropriate use of advanced surgical techniques such as en bloc resection and the use of stereotactic body radiotherapy (SBRT) to optimize patient care.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 1_suppl","pages":"5S"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of Molecular Prognostication for Common Solid Tumor Histologies - What the Surgeon Should Know.","authors":"C Rory Goodwin, Rafael De la Garza Ramos, Chetan Bettegowda, Ori Barzilai, Patel Shreyaskumar, Michael G Fehlings, Ilya Laufer, Arjun Sahgal, Laurence D Rhines, Jeremy J Reynolds, Aron Lazary, Alessandro Gasbarrini, Nicolas Dea, Jorrit-Jan Verlaan, Patricia Zadnik Sullivan, Ziya L Gokaslan, Charles G Fisher, Stefano Boriani, John H Shin, Francis J Hornicek, Michael H Weber, Matthew L Goodwin, Raphaële Charest-Morin","doi":"10.1177/21925682241250327","DOIUrl":"10.1177/21925682241250327","url":null,"abstract":"<p><strong>Study design: </strong>Narrative Literature review.</p><p><strong>Objective: </strong>To provide a general overview of important molecular markers and targeted therapies for the most common neoplasms (lung, breast, prostate and melanoma) that metastasize to the spine and offer guidance on how to best incorporate them in the clinical setting.</p><p><strong>Methods: </strong>A narrative review of the literature was performed using PubMed, Google Scholar, Medline databases, as well as the histology-specific National Comprehensive Cancer Network guidelines to identify relevant articles limited to the English language. Relevant articles were reviewed for commonly described molecular mutations or targeted therapeutics, as well as associated clinical outcomes, and surgery-related risks.</p><p><strong>Results: </strong>Molecular markers and targeted therapies have dramatically improved the survival of cancer patients. The increasing importance of prognostic molecular markers and targeted therapies provides rationale for their incorporation into clinical decision-making for patients diagnosed with metastatic spine disease. In this review, we discuss the molecular markers/mutations and targeted therapies associated with the most common malignancies that metastasize to the spine and provide a framework that the surgeon can utilize when evaluating patients for potential intervention. Finally, we provide case examples that highlight the importance of molecular prognostication and therapies in surgical decision-making.</p><p><strong>Conclusion: </strong>An integrated understanding of the implications of surgery, radiation, molecular markers and targeted therapies that guide prognostication and treatment is warranted in order to achieve the most favorable outcomes for patients with metastatic spine disease.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 1_suppl","pages":"6S-15S"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the Optimal Management of Metastatic Spine Patients With Intermediate Spinal Instability Neoplastic Scores: To Operate or Not to Operate?","authors":"William Chu Kwan, Scott L Zuckerman, Charles G Fisher, Ilya Laufer, Dean Chou, John E O'Toole, Markus Schultheiss, Michael H Weber, Daniel M Sciubba, Markian Pahuta, John H Shin, Michael G Fehlings, Anne Versteeg, Matthew L Goodwin, Stefano Boriani, Chetan Bettegowda, Aron Lazary, Alessandro Gasbarrini, Jeremy J Reynolds, Jorrit-Jan Verlaan, Arjun Sahgal, Ziya L Gokaslan, Laurence D Rhines, Nicolas Dea","doi":"10.1177/21925682231220551","DOIUrl":"https://doi.org/10.1177/21925682231220551","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review.</p><p><strong>Objective: </strong>In patients with extradural metastatic spine disease, we sought to systematically review the outcomes and complications of patients with intermediate Spinal Instability Neoplastic Score (SINS) lesions undergoing radiation therapy, percutaneous interventions, minimally invasive surgeries, or open spinal surgeries.</p><p><strong>Methods: </strong>Following PRISMA guidelines for systematic reviews, MEDLINE, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews and the Cochrane Center Register of Controlled Trials were queried for studies that reported on SINS intermediate patients who underwent: 1) radiotherapy, 2) percutaneous intervention, 3) minimally invasive, or 4) open surgery. Dates of publication were between 2013-22. Patients with low- or high-grade SINS were excluded. Outcome measures were pain score, functional status, neurological outcome, ambulation, survival, and perioperative complications.</p><p><strong>Results: </strong>Thirty-nine studies (n = 4554) were included that analyzed outcomes in the SINS intermediate cohort. Radiotherapy appeared to provide temporary improvement in pain score; however, recurrent pain led to surgery in 15%-20% of patients. Percutaneous vertebral augmentation provided improvement in pain. Minimally invasive surgery and open surgery offered improvement in pain, quality of life, neurological, and ambulatory outcomes. Open surgery may be associated with more complications. There was limited evidence for radiofrequency ablation.</p><p><strong>Conclusion: </strong>In the SINS intermediate group, radiotherapy was associated with temporary improvement of pain but may require subsequent surgery. Both minimally invasive surgery and open spinal surgery achieved improvements in pain, quality of life, and neurological outcomes for patients with spine metastases. Open surgery may be associated with more complications.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 1_suppl","pages":"132S-142S"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Lumbar Lordosis is Associated With Reoperation for Adjacent Segment Disease After Lumbar Fusion for Degenerative Conditions.","authors":"Ragavan Manoharan, Ahmed Cherry, Aditya Raj, Nisaharan Srikandarajah, Mark Xu, Carlo Iorio, Christopher J Nielsen, Yoga Raja Rampersaud, Stephen J Lewis","doi":"10.1177/21925682241262704","DOIUrl":"10.1177/21925682241262704","url":null,"abstract":"<p><strong>Study design: </strong>A single centre retrospective review.</p><p><strong>Objective: </strong>Recent studies have suggested that distal lordosis (L4-S1, DL) remains constant across all pelvic incidence (PI) subgroups, whilst proximal lordosis (L1-L4, PL) varies. We sought to investigate the impact of post-operative DL on adjacent segment disease (ASD) requiring reoperation in patients undergoing lumbar fusion for degenerative conditions.</p><p><strong>Methods: </strong>Patients undergoing 1-3 level lumbar fusion with the two senior authors between 2007-16 were included. Demographic and radiographic data were recorded. Univariate, multivariate binary logistic regression, and Kaplan Meier survivorship analyses were performed.</p><p><strong>Results: </strong>335 patients were included in the final analysis. Most had single (67%) or two (31%) level fusions. The mean follow-up was 64-month. Fifty-seven patients (17%) underwent reoperation for ASD at an average of 78-month post-operatively (R group). The R group had a significantly lower mean post-operative DL (27.3 vs 31.1 deg, <i>P</i> < .001) and mean PI (55.5 vs 59.2 deg, <i>P</i> < .05). On univariate analysis, patients with a post-operative DL of <35 deg had higher odds of reoperation for ASD than those with a post-operative DL of ≥35 deg (OR 2.7, <i>P</i> = .016). In the multivariate model, post-operative DL, low/average PI, and spondylolisthesis were all significantly associated with reoperation for ASD.</p><p><strong>Conclusion: </strong>This study provides preliminary support to an association between post-operative distal lumbar lordosis and risk of reoperation for ASD in patients undergoing fusions for degenerative conditions. Further multicentre prospective study is needed to independently confirm this association and identify the impact of restoration of physiological distal lumbar lordosis on long term patient outcomes.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"143-151"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion Tensor Imaging in Diagnosing and Evaluating Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis.","authors":"Mohammad Mohammadi, Faramarz Roohollahi, Farzin Farahbakhsh, Aynaz Mohammadi, Elham Mortazavi Mamaghani, Samuel Berchi Kankam, Azin Moarrefdezfouli, Afshar Ghamari Khameneh, Mohamad Mahdi Mahmoudi, Davit Baghdasaryan, Allan R Martin, James Harrop, Vafa Rahimi-Movaghar","doi":"10.1177/21925682241263792","DOIUrl":"10.1177/21925682241263792","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review.</p><p><strong>Objective: </strong>Degenerative cervical myelopathy (DCM) is a common spinal cord disorder necessitating surgery. We aim to explore how effectively diffusion tensor imaging (DTI) can distinguish DCM from healthy individuals and assess the relationship between DTI metrics and symptom severity.</p><p><strong>Methods: </strong>We included studies with adult DCM patients who had not undergone decompressive surgery and implemented correlation analyses between DTI parameters and severity, or compared healthy controls and DCM patients.</p><p><strong>Results: </strong>57 studies were included in our meta-analysis. At the maximal compression (MC) level, fractional anisotropy (FA) exhibited lower values in DCM patients, while apparent diffusion coefficient (ADC), mean diffusivity (MD), and radial diffusivity (RD) were notably higher in the DCM group. Moreover, our investigation into the diagnostic utility of DTI parameters disclosed high sensitivity, specificity, and area under the curve values for FA (.84, .80, .83 respectively) and ADC (.74, .84, .88 respectively). Additionally, we explored the correlation between DTI parameters and myelopathy severity, revealing a significant correlation of FA (.53, 95% CI:0.40 to .65) at MC level with JOA/mJOA scores.</p><p><strong>Conclusion: </strong>Current guidelines for DCM suggest decompressive surgery for both mild and severe cases. However, they lack clear recommendations on which mild DCM patients might benefit from conservative treatment vs immediate surgery. ADC's role here could be pivotal, potentially differentiating between healthy individuals and DCM. While it may not correlate with symptom severity, it might predict surgical outcomes, making it a valuable imaging biomarker for clearer management decisions in mild DCM.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"267-283"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141320836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Critical Appraisal of the Application of Frailty and Sarcopenia in the Spinal Oncology Population.","authors":"Mark A MacLean, Antoinette J Charles, Miltiadis Georgiopoulos, Jackie Phinney, Raphaële Charest-Morin, Rory Goodwin, Ilya Laufer, Michael G Fehlings, John Shin, Nicholas Dea, Laurence D Rhines, Arjun Sahgal, Ziya Gokaslan, Byron Stephens, Alexander C Disch, Naresh Kumar, John O'Toole, Daniel M Sciubba, Cordula Netzer, Tony Goldschlager, Wende Gibbs, Michael H Weber","doi":"10.1177/21925682231207325","DOIUrl":"https://doi.org/10.1177/21925682231207325","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review and clinimetric analysis.</p><p><strong>Objectives: </strong>Frailty and sarcopenia predict worse surgical outcomes among spinal degenerative and deformity-related populations; this association is less clear in the context of spinal oncology. Here, we sought to identify frailty and sarcopenia tools applied in spinal oncology and appraise their clinimetric properties.</p><p><strong>Methods: </strong>A systematic review was conducted from January 1^st, 2000, until June 2022. Study characteristics, frailty tools, and measures of sarcopenia were recorded. Component domains, individual items, cut-off values, and measurement techniques were collected. Clinimetric assessment was performed according to Consensus-based Standards for Health Measurement Instruments.</p><p><strong>Results: </strong>Twenty-two studies were included (42 514 patients). Seventeen studies utilized 6 frailty tools; the three most employed were the Metastatic Spine tumor Frailty Index (MSTFI), Modified Frailty Index-11 (mFI-11), and the mFI-5. Eight studies utilized measures of sarcopenia; the three most common were the L3-Total Psoas Area (TPA)/Vertebral Body Area (VBA), L3-TPA/Height², and L3-Spinal Muscle Index (L3-Cross-Sectional Muscle Area/Height²). Frailty and sarcopenia measures lacked or had uncertain content and construct validity. Frailty measures were objective except the Johns-Hopkins Adjusted Clinical Groups. All tools were feasible except the Hospital Frailty Risk Score (HFRS). Positive predictive validity was observed for the HFRS and in select studies employing the mFI-5, MSTFI, and L3-TPA/VBA. All frailty tools had floor or ceiling effects.</p><p><strong>Conclusions: </strong>Existing tools for evaluating frailty and sarcopenia among patients undergoing surgery for spinal tumors have poor clinimetric properties. Here, we provide a pragmatic approach to utilizing existing frailty and sarcopenia tools, until more clinimetrically robust instruments are developed.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 1_suppl","pages":"47S-80S"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPINE20 Recommendations 2024 -Spinal Disability: Social Inclusion as a Key to Prevention and Management.","authors":"Cristiano M Menezes, Carlos Tucci, Koji Tamai, Harvinder S Chhabra, Fahad H Alhelal, André E Bussières, Eric J Muehlbauer, Lisa Roberts, Hana I Alsobayel, Guido Barneschi, Marco A Campello, Pierre Côté, Luís Miguel Duchén Rodríguez, Alexandre F Cristante, Komal Kamra, Kazuya Kitamura, Robert Meves, Marcelo I Risso-Neto, Adriaan J Vlok, Sanjay Wadhwa, Karsten Wiechert, Ratko Yurac, Thomas Blattert, Giuseppe Costanzo, Bambang Darwono, Margareta Nordin, Yahya S Al Athbah, Ahmed Alturkistany, Rupinder Chahal, Joerg Franke, Manabu Ito, Markus Arand, Paulo Pereira, Carlo Ruosi, William J Sullivan, André L F Andújar, Carlos Henrique Ribeiro, Luis Eduardo Carelli, Jamir Sardá, Ana Lígia G E Machado, Sami AlEissa","doi":"10.1177/21925682241290226","DOIUrl":"10.1177/21925682241290226","url":null,"abstract":"<p><p>Spine disorders are the leading cause of disability worldwide. To promote social inclusion, it is essential to ensure that people can participate in their societies by improving their ability, opportunities, and dignity, through access to high-quality, evidence-based, and affordable spine services for all.To achieve this goal, SPINE20 recommends six actions.- SPINE20 recommends that G20 countries deliver evidence-based education to the community health workers and primary care clinicians to promote best practice for spine health, especially in underserved communities.- SPINE20 recommends that G20 countries deliver evidence-based, high-quality, cost-effective spine care interventions that are accessible, affordable and beneficial to patients.- SPINE20 recommends that G20 countries invest in Health Policy and System Research (HPSR) to generate evidence to develop and implement policies aimed at integrating rehabilitation in primary care to improve spine health.- SPINE20 recommends that G20 countries support ongoing research initiatives on digital technologies including artificial intelligence, regulate digital technologies, and promote evidence-based, ethical digital solutions in all aspects of spine care, to enrich patient care with high value and quality.- SPINE20 recommends that G20 countries prioritize social inclusion by promoting equitable access to comprehensive spine care through collaborations with healthcare providers, policymakers, and community organizations.- SPINE20 recommends that G20 countries prioritize spine health to improve the well-being and productivity of their populations. Government health systems are expected to create a healthier, more productive, and equitable society for all through collaborative efforts and sustained investment in evidence-based care and promotion of spine health.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"8-20"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142463179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Issue 8: \"End of Year Recap\".","authors":"Jeffrey C Wang, Jens R Chapman, Karsten Wiechert","doi":"10.1177/21925682241284842","DOIUrl":"10.1177/21925682241284842","url":null,"abstract":"","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 1","pages":"7"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latest Developments in Targeted Biological Therapies in the Management of Chordoma and Chondrosarcoma.","authors":"Adam Biczo, Arjun Sahgal, Jorrit-Jan Verlaan, Patel Shreyaskumar, Zsolt Szoverfi, Markus Schultheiss, Laurence Rhines, Jeremy Reynolds, Ilya Laufer, Alessandro Gasbarrini, Nicolas Dea, Ziya Gokaslan, Charles Fisher, Chetan Bettegowda, Stefano Boriani, Francis Hornicek, Rory Goodwin, Aron Lazary","doi":"10.1177/21925682241227917","DOIUrl":"https://doi.org/10.1177/21925682241227917","url":null,"abstract":"<p><strong>Study design: </strong>Systematic review.</p><p><strong>Objectives: </strong>The objective of this review paper was to summarize targeted molecular therapy options for spinal chordoma and chondrosarcoma, and to provide an update on the relevant clinical trials open for recruitment.</p><p><strong>Methods: </strong>A systematic review of the current literature was performed, according to PRISMA guidelines, to summarize the latest developments in non-surgical molecular treatment options for low grade malignant primary spinal tumours. We also summarize those actively recruiting clinical trials based on clinicaltrials.gov.</p><p><strong>Results: </strong>A total of 73 studies and completed clinical trials were reviewed. Twenty actively recruiting clinical trials (eight for chordoma and twelve for chondrosarcoma) were identified.</p><p><strong>Conclusions: </strong>There is a strong need to find new therapeutic options to complement surgical resection and radiation therapy, which remain the cornerstone of management. Targeted therapies against molecular pathways show promise as compared to conventional chemotherapy.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 1_suppl","pages":"120S-131S"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Posterior Carbon Fiber Implants in Spine Tumor Surgery.","authors":"Christopher A Alvarez-Breckenridge, Robert North, Claudio Tatsui, Naresh Kumar, Sheng-Fu Lo, Karim Mohammed, Jeremy Reynolds, Aron Lazary, Ilya Laufer, Jorrit Jan Verlaan, Ziya Gokaslan, Alessandro Luzzati, Riccardo Cecchinato, John Shin, Francis Hornicek, Alexander Disch, Matthew Goodwin, Rory Goodwin, Arjun Sahgal, Alessandro Gasbarrini, Stefano Boriani","doi":"10.1177/21925682241259778","DOIUrl":"10.1177/21925682241259778","url":null,"abstract":"<p><strong>Study design: </strong>Narrative Review.</p><p><strong>Objective: </strong>The management of spinal tumors requires a multi-disciplinary approach including surgery, radiation, and systemic therapy. Surgical approaches typically require posterior segmental instrumentation to maintain long-term spinal stability. Carbon fiber reinforced pedicle screws (CFRP) are increasingly used in the oncologic setting due to reductions in both imaging artifacts and radiotherapy perturbations compared to titanium implants. We performed a review of the literature and highlight advantages and future areas of study for CFRP.</p><p><strong>Methods: </strong>We performed a systematic review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and identified 10 articles including 573 patients. Across all studies we reviewed patient demographics, tumor types treated, hardware-related features, complication rates, recurrence, survival, and follow-up.</p><p><strong>Results: </strong>Across 10 studies, a total of 1371 screws placed. Surgical and non-surgical complications were reported in 18.3% of patients. Disease progression at the surgical site was detected in 7.3% of patients. There was no significant difference in clinical or hardware complications between CFRP or titanium implants. The most frequent complication attributable to implanted CFRP hardware included screw breakage in 2.4% and loosening in 1.7% of patients, respectively.</p><p><strong>Conclusion: </strong>CFRP provide a unique tool in the setting of spinal oncology. With a safety profile comparable to titanium, we review the documented advantages of CFRP posterior implants compared to titanium, while also addressing their current limitations. Additionally, we highlight several areas of future research to identify the optimal patients who will achieve the greatest benefit of CFRP.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":"15 1_suppl","pages":"157S-165S"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}