|Beitragstitel||Preliminary clinical and radiological results of an expandable PEEK-Cage as anterior vertebral body replacement|
Recently cages fully made from PEEK or carbon became popular especially in tumor surgery. They are mostly crafted as monobody cages without expandable options. This study was set up to evaluate the applicability, efficacy and safety of a new expandable PEEK cage as vertebral body replacement.
Consecutively implanted PEEK-XRL-Cages® (Depuy/Synthes) for anterior column reconstruction in thoracolumbar trauma and tumor cases were retrospectively analyzed. The modular implant consists of a central body which can be filled with bone graft on which two endplates are attached. All parts can be customized to the individual intraoperative situation. Clinical and radiological follow up were performed 2, 6 and 12 months post operatively. After 12 months a CT scan was performed in most cases to evaluate osseous consolidation. Standing- x-rays were performed at every follow-up. Bi-segmental kyphosis angle and cage height were measured. Descriptive analyses have been executed.
52 cages have been implanted since 2013 (31 male, mean age 45.9 y); 42 in trauma (15 paraplegic), 10 in spinal metastatic diseases; 1 mono-segmental, 38 bi-segmental and 3 three-segmental ventral fusions were performed. There were no intraoperative and 4 perioperative complications: two hematomas and one wound breakdown. One patient died ten days post-operatively due to his underlying tumor disease. 39 patients could be followed up for a mean of 0.7 (0.1- 2.5) years. The radiologic analysis showed 2 cases of implant malpositioning and 4 cases of early subsidence which were all secondary stable. No revision surgery was required in all cases. No collapse or malfunction of the modular expansion system was documented. A mean loss of two degrees bi-segmental lordotic correction angle was documented in the last follow up (mean 0.7 years). 23 patients received a CT-scan at mean 0.9 years post-operatively. 18 showed continuous, 5 showed incomplete osseous consolidation with stable implants.
The modular, expandable XRL-PEEK-Cage showed promising preliminary clinical and radiological results in 39 cases with a mean follow up of 0.7 years. No implant related complication or collapse of the cage itself could be seen. Therefore, the implant seems to be save for anterior vertebral body reconstruction in trauma and tumor patients. Further extensive long term data need to be evaluated.