Single Institute Experience with Carbon Fiber-reinforced Polymers in Patients with Spinal Oncologic Disease: 26 Patient Cohort

Introduction: Spinal tumors often require surgical intervention, including stabilization with spinal instrumentation, to prevent structural collapse and neurological compromise. Traditional metal hardware, while effective, can be associated with complications such as hardware failure, infection, and interference with imaging modalities. Novel carbon fiber-reinforced polymer (CFRP) spinal instrumentation systems offer potential advantages, including radiolucency, improved biocompatibility and reduced complication rates. This study retrospectively assesses the hardware complication rates associated with CFRP spinal instrumentation in patients with spinal tumors

Methods: A retrospective review was conducted on 26 patients who underwent spinal instrumentation using CFRP hardware following surgery for spinal tumors (Pedicle Screws and/or Rods). Of these, 10 patients received hybrid constructs. A total of 168 screws were placed across 98 levels. Data were collected on patient demographics, tumor characteristics, surgical details, and postoperative outcomes, with a particular focus on hardware-related complications, such as screw loosening, breakage, and infections. The follow-up period ranged from 3 months to 18.8 months.

Results: In the cohort of 26 patients, no hardware-related complications were observed during the follow-up period. All patients showed stable spinal constructs without evidence of hardware failure, loosening, or infection. The radiolucency of the CFRP system also allowed for clearer postoperative imaging, facilitating better assessment of tumor progression and response to treatment as well as identifying non-hardware related complications (e.g. CSF leak, etc)

Conclusion : The findings of this study indicate that CFRP spinal instrumentation is a safe and effective option for patients undergoing surgery for spinal tumors. The absence of hardware complications in this retrospective analysis suggests that CFRP constructs may offer advantages over traditional metal instrumentation, particularly in reducing the risk of hardware failure and improving postoperative imaging. Further prospective multicenter studies with larger patient populations are recommended to validate these findings and explore the long-term outcomes of CFRP use in spinal tumor surgery.