Clinical evaluation of vertebral body replacement of carbon fiber–reinforced polyetheretherketone in patients with tumor manifestation of the thoracic and lumbar spine

PURPOSE: Radiolucent anterior and posterior implants by carbon fiber–reinforced polyetheretherketone (CFR PEEK) aim to improve treatment of primary and secondary tumors of the spine during the last years. The aim of this study was to evaluate clinical and radiological outcomes after dorsoventral instrumentation using a CFR PEEK implant in a cohort of patients representing clinical reality. METHODS: A total of 25 patients with tumor manifestation of the thoracic and lumbar spine underwent vertebral body replacement (VBR) using an expandable CFR PEEK implant between January 2021 and January 2022. Patient outcome, complications, and radiographic follow-up were analyzed. RESULTS: A consecutive series aged 65.8 ± 14.7 (27.6–91.2) years were treated at 37 vertebrae of tumor manifestation, including two cases (8.0%) of primary tumor as well as 23 cases (92.0%) of spinal metastases. Overall, 26 cages covering a median of 1 level (1–4) were implanted. Duration of surgery was 134 ± 104 (65–576) min, with a blood loss of 792 ± 785 (100–4000) ml. No intraoperative cage revision was required. Surgical complications were reported in three (12.0%) cases including hemothorax in two cases (one intraoperative, one postoperative) and atrophic wound healing disorder in one case. In two cases (8.0%), revision surgery was performed (fracture of the adjacent tumorous vertebrae, progressive construct failure regarding cage subsidence). No implant failure was observed. CONCLUSION: VBR using CFR PEEK cages represents a legitimate surgical strategy which opens a variety of improvements—especially in patients in need of postoperative radiotherapy of the spine and MRI-based follow-up examinations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00701-023-05502-z.