放射性碳纤维椎弓根螺钉在非肿瘤性脊柱手术中的应用：11例临床研究

IF 0.5 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2025-09-03 DOI:10.1016/j.inat.2025.102121

Ralph J Mobbs , Daniel B Breuninger

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引用次数: 0

摘要

金属椎弓根螺钉，特别是钛金属，可引起明显的成像伪影，并可能导致应力屏蔽。碳纤维增强聚醚醚酮（CFR-PEEK）椎弓根螺钉具有放射透光性和更像骨的弹性模量，在非肿瘤性脊柱手术中可能改善术后成像并减少与植入物相关的并发症。目的评价CFR-PEEK椎弓根螺钉在一系列非肿瘤性脊柱手术中的临床和影像学效果，包括骨质疏松、创伤和骨不连翻修等退行性疾病。方法回顾性分析了11例于2022年6月6日至2024年7月8日在同一家机构接受CFR-PEEK椎弓根螺钉固定治疗的非肿瘤性脊柱病理患者。数据包括患者人口统计学、手术入路、放射融合和并发症。结果平均年龄60岁，4例为脊柱不连矫正，4例为退行性疾病，3例为脊髓压迫和/或创伤。术后影像学证实，由于螺钉的透光性，骨解剖和神经结构的清晰度得到了提高，所有患者在最后随访时均实现了融合。在撰写本文时，没有任何患者出现与植入物相关的并发症。结论cfr - peek椎弓根螺钉在11例非肿瘤病例中提供了令人满意的稳定，使术后成像更清晰，并在减少应力屏蔽方面提供了理论上的优势。到目前为止，没有患者需要翻修，尽管不能排除未来的并发症。如果相邻节段病理需要额外的融合，现有碳基螺钉扩展结构的生物力学意义仍然不确定，需要进一步研究。需要更大规模的前瞻性试验来验证这些发现并确定最佳患者选择。

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Radiolucent carbon fibre pedicle screws in non-oncologic spinal surgery: A clinical series of 11 patients

Background

Metal pedicle screws, particularly titanium, can cause significant imaging artifacts and may lead to stress shielding. Carbon fibre–reinforced polyetheretherketone (CFR-PEEK) pedicle screws offer radiolucency and a more bone-like modulus of elasticity, potentially improving postoperative imaging and reducing implant-related complications in non-oncologic spinal surgery.

Objective

To evaluate the clinical and radiographic outcomes of CFR-PEEK pedicle screws in a series of non-oncologic spinal surgeries, covering degenerative disease in the setting of osteoporosis, trauma, and revision for non-union.

Methods

We retrospectively reviewed 11 consecutive patients who underwent CFR-PEEK pedicle screw fixation at a single institution for non-oncologic spinal pathology between June 6, 2022, and July 8, 2024. Data included patient demographics, surgical approach, radiographic fusion and complications.

Results

Mean age was 60 years, with 4 cases for revision of non-union, 4 cases for degenerative disease, and 3 for spinal cord compression and/or trauma. Postoperative imaging confirmed improved clarity of bony anatomy and neural structures due to the screws’ radiolucency, and all patients achieved fusion at final follow-up. There have been no implant-related complications in any patient at the time of this writing.

Conclusion

CFR-PEEK pedicle screws provided satisfactory stabilisation in this series of 11 non-oncologic cases, enabling clearer postoperative imaging and offering a theoretical advantage in reducing stress shielding. No patient has required revision to date, although future complications cannot be excluded. If adjacent segment pathology were to necessitate additional fusion, the biomechanical implications of extending constructs with existing carbon-based screws remain uncertain and warrant further study. Larger prospective trials are needed to validate these findings and define optimal patient selection.

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