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Journal article
Do PEEK Rods for Posterior Instrumented Fusion in the Lumbar Spine Reduce the Risk of Adjacent Segment Disease?
International journal of spine surgery, v 15(2), pp 251-258
01 Apr 2021
PMID: 33900982
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Polyetheretherketone (PEEK) rods were clinically introduced in the mid-2000s as an alternative to titanium (Ti) rods for posterior instrumented lumbar spine fusion, theorized to reduce the risk of adjacent segment disease (ASD). However, few studies have follow-up beyond 2 years. Consequently, we conducted a matched cohort study using data from Kaiser Permanente's spine registry to compare the 2 rod systems and risk for outcomes.
Methods: Patients aged similar to 18 undergoing first posterior lumbar fusion for a degenerative diagnosis from 2009 to 2018 using either a PEEK or a Ti rod were identified. Fusions using Ti rods were 2:1 propensity score matched to PEEK rods on the following factors: patient age, body mass index, smoking, American Society of Anesthesiologists classification, diagnosis, interbody use, bone morphogenic protein use, number of levels fused, fusion levels, and operative year. The matched sample included 154 PEEK and 308 Ti fusions. We used Cox regression to evaluate ASD and nonunion, and logistic regression to evaluate 90-day emergency department (ED) visit, readmission, and complication.
Results: We did not observe a difference in risk for ASD (hazard ratio = 1.02, 95% confidence interval [CI] = 0.661.59) or ED visit (odds ratio [OR] = 0.88, 95% CI = 0.48-1.59). A lower likelihood of readmission (OR = 0.34, 95% CI = 0.13-0.94) was observed following PEEK fusion compared with Ti. No nonunions or 90-day complications were observed for the PEEK group; 5 (2-year cumulative incidence = 0.7%) nonunions and 4 (1.3%) complications were observed for the Ti group.
Conclusions: Our multicenter study did not support the hypothesis that PEEK rods are associated with a lower ASD risk. Reasons for readmission need to be identified to better understand the differences observed here. Further study of patients with TLIF using Ti and PEEK rods and posterolateral fusion with Ti and PEEK rods is needed.
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Details
- Title
- Do PEEK Rods for Posterior Instrumented Fusion in the Lumbar Spine Reduce the Risk of Adjacent Segment Disease?
- Creators
- Daniel Hirt - Los Angeles Medical CenterHeather A. Prentice - Kaiser PermanenteJessica E. Harris - Kaiser PermanenteElizabeth W. Paxton - Kaiser PermanenteJessa Alexander - University of California, San FranciscoDaniel T. Nagasawa - Achieve Brain and Spine Surgery, Santa Monica, California.Deven Khosla - Achieve Brain and Spine Surgery, Santa Monica, California.Steven M. Kurtz - Exponent (United States)
- Publication Details
- International journal of spine surgery, v 15(2), pp 251-258
- Publisher
- Int Soc Advancement Spine Surgery-Isass
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- School of Biomedical Engineering, Science, and Health Systems
- Web of Science ID
- WOS:000640535000008
- Scopus ID
- 2-s2.0-85105305412
- Other Identifier
- 991019167542204721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- Web of Science research areas
- Surgery