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Safety and efficacy of polyetheretherketone (PEEK) cages in combination with posterior pedicel screw fixation in pyogenic spinal infection

  • Clinical Article - Spine
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Abstract

Background

To date, there is growing consensus that PEEK material may be used for interbody fusion in spinal infections. Data supporting that claim are however restricted to a few very small clinical series. The aim of this study is to evaluate the outcome of surgical treatment of pyogenic spinal infections with PEEK cages in combination with posterior pedicel screw fixation.

Methods

Between 2006 and 2013, a total of 211 patients suffering from spondylodiscitis underwent surgical debridement and instrumentation. There were 52 cases where PEEK cages were used. Laboratory and physical examinations were assessed at a 3-month follow-up. Last follow-up was performed with at a minimum of 12 months after surgery via a telephone interview.

Results

Mean age at presentation was 67 years, with 19 (37 %) male patients and 33 (63 %) female. Distribution of the infection was lumbar in 29 (56 %%), thoracic in 3 (6 %) and cervical in 11 (21 %) cases. Nine patients (17 %) had concomitant non-contiguous spondylodiscitis. Epidural abscess was found in 17 patients (33 %); 48 (92 %%) had pain; neurological deficits were found in 20 patients (38 %). All patients in this series underwent surgical debridement with instrumentation of the spine. Postoperative intravenous antibiotics were administered for 15.4 ± 6.8 days followed by 2.9 ± 0.5 months of oral antibiotics. Complete resolution of the infection was achieved in all cases. Of the 28 patients with neurological deficits, 6 had full recovery and 10 had improved incompletely after surgery. One patient suffered from a pulmonary embolism postoperatively. There were no mortalities.

Conclusions

Use of PEEK cages for interbody fusion is feasible and safe in patients suffering from a pyogenic spinal infection.

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Author notes

    Authors and Affiliations

    1. Neurochirurgische Klinik und Poliklinik, Technische Universität München, Klinikum rechts der Isar, München, Germany

      Ehab Shiban, Insa Janssen, Jessica Rainer, Michael Stoffel, Jens Lehmberg, Florian Ringel & Bernhard Meyer

    2. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany

      Ehab Shiban

    3. Serviço de Neurocirurgia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal

      Pedro Ribeiro da Cunha

    4. Klinik für Neurochirurgie, Helios Kliniken, Krefeld, Germany

      Michael Stoffel

    5. Neurochirurgische Klinische und Poliklinik, Universitätsklinikum Mainz, Mainz, Germany

      Florian Ringel

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    1. Ehab Shiban
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    2. Insa Janssen
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    3. Pedro Ribeiro da Cunha
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    4. Jessica Rainer
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    Correspondence to Ehab Shiban.

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    No funding was received for this research.

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    None.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

    Disclosure

    The study was completly financed by the department of neurosurgery of technical university of munich.

    Additional information

    Ehab Shiban and Insa Janssen contributed equally to this work.

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    Shiban, E., Janssen, I., da Cunha, P.R. et al. Safety and efficacy of polyetheretherketone (PEEK) cages in combination with posterior pedicel screw fixation in pyogenic spinal infection. Acta Neurochir 158, 1851–1857 (2016). https://doi.org/10.1007/s00701-016-2924-z

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    • DOI: https://doi.org/10.1007/s00701-016-2924-z

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