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Radiological and clinical outcomes of novel Ti/PEEK combined spinal fusion cages: a systematic review and preclinical evaluation

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Abstract

Purpose

The primary objective of this paper was to provide a systematic review of the available clinical studies of Ti/PEEK combined cages in spinal interbody fusion surgeries, focusing on their radiological and clinical outcomes. A secondary aim was to provide a review and evaluation of the in vitro and preclinical studies reported on Ti/PEEK-coated implants.

Methods

A systematic search of the literature was performed in March 2015 via three databases: Medline, Embase and Cochrane library. The following key search terms were combined with synonyms to identify relevant articles: “spinal fusion,” “PEEK,” “titanium” and “cage.”

Results

The novelty of this intervention translates into a paucity of clinical trials, albeit the results of the seven clinical studies that met the criteria for inclusion are promising. All studies reported rate of fusion as a primary outcome. Two studies reported slightly improved fusion in the experimental Ti/PEEK combination cohort, one study identical fusion (91.7 %) and three studies excellent fusion (96, 100 and 94 %) in the Ti/PEEK cohort, although no differences reached statistical significance.

Conclusions

Clinical studies at this early stage demonstrate that Ti/PEEK implants are safe and efficacious, exhibiting similar fusion rates and clinical outcomes compared to the current standard PEEK. There is clinical evidence substantiating the improved radiographic fusion of Ti/PEEK, albeit the differences were not significant. This field is promising, gaining substantial popularity, and further clinical trials are needed in the future to establish Ti/PEEK cages as a mainstay of clinical practice.

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Authors and Affiliations

  1. Faculty of Medicine, University of New South Wales, Kensington, Sydney, Australia

    Yusuf Assem

  2. Surgical and Orthopaedic Research Laboratory, Prince of Wales Clinical School, UNSW, Sydney, Australia

    Yusuf Assem, Matthew H. Pelletier & William R. Walsh

  3. Neurospine Clinic, Prince of Wales Private Hospital, Barker St, Randwick, NSW, 2031, Australia

    Yusuf Assem, Ralph J. Mobbs & Kevin Phan

  4. NeuroSpine Surgery Research Group (NSURG), Sydney, Australia

    Ralph J. Mobbs & Kevin Phan

  5. Department of Spine Surgery, Prince of Wales Private Hospital, Barker St, Sydney, 2031, Australia

    Ralph J. Mobbs

Authors
  1. Yusuf Assem
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  2. Ralph J. Mobbs
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  3. Matthew H. Pelletier
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  4. Kevin Phan
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  5. William R. Walsh
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Correspondence to Ralph J. Mobbs.

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Assem, Y., Mobbs, R.J., Pelletier, M.H. et al. Radiological and clinical outcomes of novel Ti/PEEK combined spinal fusion cages: a systematic review and preclinical evaluation. Eur Spine J 26, 593–605 (2017). https://doi.org/10.1007/s00586-015-4353-8

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  • DOI: https://doi.org/10.1007/s00586-015-4353-8

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