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Titanium-coated PEEK Versus Uncoated PEEK Cages in Lumbar Interbody Fusion: A Systematic Review and Meta-analysis of Randomized Controlled Trial

Systematic review and meta-analysis. OBJECTIVE: This study was performed to compare the fusion and subsidence rate of titanium-coated polyetheretherketone (Ti-PEEK) versus polyetheretherketone (PEEK) cages after lumbar fusion and to investigate the clinical effect on patient-reported outcomes (PROMs...

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Autores principales: Lv, Zheng-tao, Xu, Yong, Cao, Bin, Dai, Jun, Zhang, Si-yuan, Huang, Jun-ming, Liang, Shuang, Jiang, Feng-xian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10231928/
https://www.ncbi.nlm.nih.gov/pubmed/35994033
http://dx.doi.org/10.1097/BSD.0000000000001378
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author Lv, Zheng-tao
Xu, Yong
Cao, Bin
Dai, Jun
Zhang, Si-yuan
Huang, Jun-ming
Liang, Shuang
Jiang, Feng-xian
author_facet Lv, Zheng-tao
Xu, Yong
Cao, Bin
Dai, Jun
Zhang, Si-yuan
Huang, Jun-ming
Liang, Shuang
Jiang, Feng-xian
author_sort Lv, Zheng-tao
collection PubMed
description Systematic review and meta-analysis. OBJECTIVE: This study was performed to compare the fusion and subsidence rate of titanium-coated polyetheretherketone (Ti-PEEK) versus polyetheretherketone (PEEK) cages after lumbar fusion and to investigate the clinical effect on patient-reported outcomes (PROMs). SUMMARY OF BACKGROUND DATA: Ti-PEEK cages have been developed to combine the advantages of both titanium alloy and PEEK, but whether they are superior to uncoated PEEK cages in bone fusion is still inconclusive. METHODS: PubMed, EMBASE, ISI Web of Science, CENTRAL, and CNKI were searched to identify randomized controlled trials that compared the efficacy of Ti-PEEK and PEEK cages in lumbar fusion. Difference in fusion rate and subsidence rate was indicated by risk ratio and its associated 95% confidence interval (95% confidence interval). Mean difference was calculated for Oswestry Disability Index and visual analogue scale for low back pain. Subgroup analysis was performed by time course after the surgery. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to evaluate the certainty of evidence. RESULTS: Four randomized controlled trials involving 325 patients (160 patients in Ti-PEEK group and 165 patients in PEEK group) that underwent lumbar fusion were included by our current study. Low to moderate evidence suggested that Ti-PEEK and PEEK cages exhibited equivalent fusion rate and subsidence rate at any follow-up time. Low to moderate evidence suggested that there was no difference in PROMs except for visual analogue scale measured at 6 months (mean difference: −0.57, 95% confidence interval −0.94, −0.21; P=0.002) but the difference was not clinically relevant according to the minimal clinically important difference. CONCLUSION: Low to moderate evidence showed that Ti-PEEK and PEEK had equivalent effect in bone fusion and cages subsidence at any follow-up time after lumbar fusion surgeries. Low to moderate evidence showed no clinically important difference in PROMs.
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spelling pubmed-102319282023-06-01 Titanium-coated PEEK Versus Uncoated PEEK Cages in Lumbar Interbody Fusion: A Systematic Review and Meta-analysis of Randomized Controlled Trial Lv, Zheng-tao Xu, Yong Cao, Bin Dai, Jun Zhang, Si-yuan Huang, Jun-ming Liang, Shuang Jiang, Feng-xian Clin Spine Surg Systematic Reviews and Meta-Analyses Systematic review and meta-analysis. OBJECTIVE: This study was performed to compare the fusion and subsidence rate of titanium-coated polyetheretherketone (Ti-PEEK) versus polyetheretherketone (PEEK) cages after lumbar fusion and to investigate the clinical effect on patient-reported outcomes (PROMs). SUMMARY OF BACKGROUND DATA: Ti-PEEK cages have been developed to combine the advantages of both titanium alloy and PEEK, but whether they are superior to uncoated PEEK cages in bone fusion is still inconclusive. METHODS: PubMed, EMBASE, ISI Web of Science, CENTRAL, and CNKI were searched to identify randomized controlled trials that compared the efficacy of Ti-PEEK and PEEK cages in lumbar fusion. Difference in fusion rate and subsidence rate was indicated by risk ratio and its associated 95% confidence interval (95% confidence interval). Mean difference was calculated for Oswestry Disability Index and visual analogue scale for low back pain. Subgroup analysis was performed by time course after the surgery. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to evaluate the certainty of evidence. RESULTS: Four randomized controlled trials involving 325 patients (160 patients in Ti-PEEK group and 165 patients in PEEK group) that underwent lumbar fusion were included by our current study. Low to moderate evidence suggested that Ti-PEEK and PEEK cages exhibited equivalent fusion rate and subsidence rate at any follow-up time. Low to moderate evidence suggested that there was no difference in PROMs except for visual analogue scale measured at 6 months (mean difference: −0.57, 95% confidence interval −0.94, −0.21; P=0.002) but the difference was not clinically relevant according to the minimal clinically important difference. CONCLUSION: Low to moderate evidence showed that Ti-PEEK and PEEK had equivalent effect in bone fusion and cages subsidence at any follow-up time after lumbar fusion surgeries. Low to moderate evidence showed no clinically important difference in PROMs. Lippincott Williams & Wilkins 2023-06 2022-08-24 /pmc/articles/PMC10231928/ /pubmed/35994033 http://dx.doi.org/10.1097/BSD.0000000000001378 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Systematic Reviews and Meta-Analyses
Lv, Zheng-tao
Xu, Yong
Cao, Bin
Dai, Jun
Zhang, Si-yuan
Huang, Jun-ming
Liang, Shuang
Jiang, Feng-xian
Titanium-coated PEEK Versus Uncoated PEEK Cages in Lumbar Interbody Fusion: A Systematic Review and Meta-analysis of Randomized Controlled Trial
title Titanium-coated PEEK Versus Uncoated PEEK Cages in Lumbar Interbody Fusion: A Systematic Review and Meta-analysis of Randomized Controlled Trial
title_full Titanium-coated PEEK Versus Uncoated PEEK Cages in Lumbar Interbody Fusion: A Systematic Review and Meta-analysis of Randomized Controlled Trial
title_fullStr Titanium-coated PEEK Versus Uncoated PEEK Cages in Lumbar Interbody Fusion: A Systematic Review and Meta-analysis of Randomized Controlled Trial
title_full_unstemmed Titanium-coated PEEK Versus Uncoated PEEK Cages in Lumbar Interbody Fusion: A Systematic Review and Meta-analysis of Randomized Controlled Trial
title_short Titanium-coated PEEK Versus Uncoated PEEK Cages in Lumbar Interbody Fusion: A Systematic Review and Meta-analysis of Randomized Controlled Trial
title_sort titanium-coated peek versus uncoated peek cages in lumbar interbody fusion: a systematic review and meta-analysis of randomized controlled trial
topic Systematic Reviews and Meta-Analyses
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10231928/
https://www.ncbi.nlm.nih.gov/pubmed/35994033
http://dx.doi.org/10.1097/BSD.0000000000001378
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