Role of Posterior Carbon Fiber Implants in Spine Tumor Surgery

Authors

Christopher A Alvarez-Breckenridge
Robert North
Claudio Tatsui
Naresh Kumar
Sheng-Fu Lo
Karim Mohammed
Jeremy Reynolds
Aron Lazary
Ilya Laufer
Jorrit Jan Verlaan
Ziya Gokaslan
Alessandro Luzzati
Riccardo Cecchinato
John Shin
Francis Hornicek
Alexander Disch
Matthew Goodwin
Rory Goodwin
Arjun Sahgal
Alessandro Gasbarrini
Stefano Boriani

Publication Date

1-1-2025

Journal

Global Spine Journal

Abstract

Study design: Narrative Review.

Objective: The management of spinal tumors requires a multi-disciplinary approach including surgery, radiation, and systemic therapy. Surgical approaches typically require posterior segmental instrumentation to maintain long-term spinal stability. Carbon fiber reinforced pedicle screws (CFRP) are increasingly used in the oncologic setting due to reductions in both imaging artifacts and radiotherapy perturbations compared to titanium implants. We performed a review of the literature and highlight advantages and future areas of study for CFRP.

Methods: We performed a systematic review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and identified 10 articles including 573 patients. Across all studies we reviewed patient demographics, tumor types treated, hardware-related features, complication rates, recurrence, survival, and follow-up.

Results: Across 10 studies, a total of 1371 screws placed. Surgical and non-surgical complications were reported in 18.3% of patients. Disease progression at the surgical site was detected in 7.3% of patients. There was no significant difference in clinical or hardware complications between CFRP or titanium implants. The most frequent complication attributable to implanted CFRP hardware included screw breakage in 2.4% and loosening in 1.7% of patients, respectively.

Conclusion: CFRP provide a unique tool in the setting of spinal oncology. With a safety profile comparable to titanium, we review the documented advantages of CFRP posterior implants compared to titanium, while also addressing their current limitations. Additionally, we highlight several areas of future research to identify the optimal patients who will achieve the greatest benefit of CFRP.

Keywords

pedicle screw, tumor, carbon fiber

DOI

10.1177/21925682241259778

PMID

39801115

PMCID

PMC11726513

PubMedCentral® Posted Date

1-12-2025

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes