Introduction: Metastatic spine tumors remain a major source of pain and neurological impairment in the oncologic patients. Separation surgery along with advancements in systemic and radiation therapy have significantly improved the survival prompting developments in operative technique. PEEK/Carbon Fiber instrumentation and shorter segment instrumentation have demonstrated benefits of improved surveillance, earlier recurrence detection and shorter operative time. We describe our initial long-term experience using PEEK/Carbon Fiber instrumentation in this population as it relates to hardware stability and construct length.
Methods: Patients with metastatic spine tumors who underwent instrumentation with PEEK/Carbon Fiber hardware at our institution between 2021-2024 were retrospectively reviewed. Only patients who had at least 6 months of postoperative imaging follow-up and underwent perioperative radiation to the primary surgical site were included. Demographics, clinical, operative and follow-up information were analyzed.
Results: 86 patients were reviewed for this study, 20 of which fit the inclusion criteria. Median age was 65, 6 were male (30%) and 14 were female (70%). The most common pathology was multiple myeloma 6 (30%), breast 5 (25%), lung adenocarcinoma 4 (20%), sarcoma 3 (15) and 1 each of renal cell and colorectal adenocarcinoma. Mean follow-up time was 14.4 months (Range 6-24.2). 13 of the patients had a short construct whereas 7 had a long construct. There was no statistically significant difference between the two groups in terms of number of vertebral bodies involved. The difference in preoperative SINS score was approaching statistical significance (p=0.058). None of the patients had hardware related complications during the follow-up period.
Conclusion : Use of PEEK/Carbon Fiber instrumentation has clinical benefit in the oncologic population. In our experience, these patients had no hardware-related complications at a mean follow-up of 14.4 months. Patients who had short segment instrumentation did not have inferior outcomes when compared to long segment, arguing for potential changes in operative planning.
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