Journal article
Titanium vs. polyetheretherketone (PEEK) interbody fusion: Meta-analysis and review of the literature
Journal of clinical neuroscience, Vol.44, pp.23-29
10/2017
DOI: 10.1016/j.jocn.2017.06.062
PMID: 28736113
Abstract
•Current literature suggests comparable Ti and PEEK cage spinal fusion rates.•Of the 2 cage materials, Ti is associated with increased subsidence.•Prospective studies should identify the benefits of one material over the other.
Spinal interbody fusion is a standard and accepted method for spinal fusion. Interbody fusion devices include titanium (Ti) and polyetheretherketone (PEEK) cages with distinct biomechanical properties. Titanium and PEEK cages have been evaluated in the cervical and lumbar spine, with conflicting results in bony fusion and subsidence. Using Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines, we reviewed the available literature evaluating Ti and PEEK cages to assess subsidence and fusion rates. Six studies were included in the analysis, 3 of which were class IV evidence, 2 were class III, and 1 was class II. A total of 410 patients (Ti-228, PEEK-182) and 587 levels (Ti-327, PEEK-260) were studied. Pooled mean age was 50.8years in the Ti group, and 53.1years in the PEEK group. Anterior cervical discectomy was performed in 4 studies (395 levels) and transforaminal interbody fusion in 2 studies (192 levels). No statistically significant difference was found between groups with fusion (OR 1.16, 95% C.I 0.59–2.89, p=0.686, I2=49.7%) but there was a statistically significant the rate of subsidence with titanium (OR 3.59, 95% C.I 1.28–10.07, p=0.015, I2=56.9%) at last follow-up. Titanium and PEEK cages are associated with a similar rate of fusion, but there is an increased rate of subsidence with titanium cage. Future prospective randomized controlled trials are needed to further evaluate these cages using surgical and patient-reported outcomes.
Details
- Title: Subtitle
- Titanium vs. polyetheretherketone (PEEK) interbody fusion: Meta-analysis and review of the literature
- Creators
- Scott Seaman - Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, United StatesPanagiotis Kerezoudis - Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United StatesMohamad Bydon - Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United StatesJames C Torner - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, United StatesPatrick W Hitchon - Department of Neurosurgery, University of Iowa Carver College of Medicine, Iowa City, IA, United States
- Resource Type
- Journal article
- Publication Details
- Journal of clinical neuroscience, Vol.44, pp.23-29
- DOI
- 10.1016/j.jocn.2017.06.062
- PMID
- 28736113
- NLM abbreviation
- J Clin Neurosci
- ISSN
- 0967-5868
- eISSN
- 1532-2653
- Publisher
- Elsevier Ltd
- Language
- English
- Date published
- 10/2017
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
- Record Identifier
- 9983996068802771
Metrics
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