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Do PEEK Rods for Posterior Instrumented Fusion in the Lumbar Spine Reduce the Risk of Adjacent Segment Disease?
Daniel Hirt1, Heather A Prentice2, Jessica E Harris2
1Department of Neurosurgery, Southern California Permanente Medical Group, Los Angeles, California.
International Journal of Spine Surgery
|April 26, 2021
Summary
Polyetheretherketone (PEEK) rods did not reduce adjacent segment disease (ASD) risk compared to titanium (Ti) rods in lumbar fusion. PEEK rods showed a lower readmission rate, but further research is needed to understand outcomes.
Area of Science:
- Spine surgery outcomes
- Biomaterials in orthopedic implants
- Clinical comparative effectiveness research
Background:
- Polyetheretherketone (PEEK) rods were introduced as an alternative to titanium (Ti) for posterior lumbar fusion, aiming to decrease adjacent segment disease (ASD).
- Limited long-term follow-up data exists for PEEK versus Ti rods.
- This study compares outcomes between PEEK and Ti rods in lumbar spine fusion.
Purpose of the Study:
- To compare the risk of adjacent segment disease (ASD) and other outcomes between Polyetheretherketone (PEEK) and titanium (Ti) rods in posterior lumbar spine fusion.
- To evaluate the midterm effectiveness and safety of PEEK rods compared to Ti rods.
Main Methods:
- A matched cohort study utilized data from a spine registry, comparing patients undergoing first posterior lumbar fusion with PEEK or Ti rods (2009-2018).
- Propensity score matching (2:1 Ti:PEEK) was performed based on multiple patient and surgical factors.
- Cox and logistic regression models assessed adjacent segment disease (ASD), nonunion, 90-day emergency department visits, readmissions, and complications.
Main Results:
- No significant difference in the risk of adjacent segment disease (ASD) or 90-day emergency department visits was observed between PEEK and Ti rods.
- A statistically significant lower likelihood of readmission was found for PEEK rod fusions compared to titanium (Ti) rods.
- No nonunions or 90-day complications occurred in the PEEK group, while the Ti group had 5 nonunions and 4 complications.
Conclusions:
- The study did not support the hypothesis that PEEK rods reduce the risk of adjacent segment disease (ASD) in lumbar fusion.
- Further investigation is required to elucidate the reasons for the observed difference in readmission rates.
- PEEK rods demonstrate midterm effectiveness and safety comparable to Ti rods for posterior lumbar fusion.
