Expandable Polyaryl-Ether-Ether-Ketone Spacers for Interbody Distraction in the Lumbar Spine

Overview

Journal Global Spine J

Publisher Sage Publications

Date 2015 Jul 2

PMID 26131383

Citations 18

Authors

Marjan Alimi

Benjamin Shin

Michael Macielak

Christoph P Hofstetter

Innocent Njoku Jr

Apostolos J Tsiouris

Eric Elowitz

Roger Hartl

Affiliations

Soon will be listed here.

Abstract

Study Design Retrospective case series. Objective StaXx XD (Spine Wave, Inc., Shelton, CT, United States) is an expandable polyaryl-ether-ether-ketone (PEEK) wafer implant utilized in the treatment of lumbar degenerative disease. PEEK implants have been successfully used as interbody devices. Few studies have focused on expandable PEEK devices. The aim of the current study is to determine the radiographic and clinical outcome of expandable PEEK cages utilized for transforaminal lumbar interbody fusion in patients with lumbar degenerative diseases. Methods Forty-nine patients who underwent lumbar interbody fusion with implantation of expandable PEEK cages and posterior instrumentation were included. The clinical outcome was evaluated using the visual analog scale (VAS) and the Oswestry Disability Index (ODI). Radiographic parameters including disk height, foraminal height, listhesis, local disk angle of the index level/levels, regional lumbar lordosis, and graft subsidence were measured preoperatively, postoperatively, and at latest follow-up. Results At an average follow-up of 19.3 months, the minimum clinically important difference for the ODI and VAS back, buttock, and leg were achieved in 64, 52, 58, and 52% of the patients, respectively. There was statistically significant improvement in VAS back (6.42 versus 3.11, p < 0.001), VAS buttock (4.66 versus 1.97, p = 0.002), VAS leg (4.55 versus 1.96, p < 0.001), and ODI (21.7 versus 12.1, p < 0.001) scores. There was a significant increase in the average disk height (6.49 versus 8.18 mm, p = 0.037) and foraminal height (15.6 versus 18.53 mm, p = 0.0001), and a significant reduction in the listhesis (5.13 versus 3.15 mm, p = 0.005). The subsidence of 0.66 mm (7.4%) observed at the latest follow-up was not significant (p = 0.35). Conclusions Midterm results indicate that expandable PEEK spacers can effectively and durably restore disk and foraminal height and improve the outcome without significant subsidence.

Citing Articles

Advancements in Custom 3D-Printed Titanium Interbody Spinal Fusion Cages and Their Relevance in Personalized Spine Care.

Lewandrowski K, Vira S, Elfar J, Lorio M J Pers Med. 2024; 14(8).

PMID: 39202002 PMC: 11355268. DOI: 10.3390/jpm14080809.

Expandable cages that expand both height and lordosis provide improved immediate effect on sagittal alignment and short-term clinical outcomes following minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Jitpakdee K, Sommer F, Gouveia E, Mykolajtchuk C, Boadi B, Berger J J Spine Surg. 2024; 10(1):55-67.

PMID: 38567017 PMC: 10982918. DOI: 10.21037/jss-23-106.

Exploring the differences in radiologic and clinical outcomes of transforaminal lumbar interbody fusion with single- and bi-planar expandable cages: a systematic review and meta-analysis.

Matsoukas S, Karabacak M, Margetis K Neurosurg Rev. 2024; 47(1):36.

PMID: 38191751 DOI: 10.1007/s10143-023-02277-w.

Transforaminal lumbar interbody fusion with an expandable interbody device: Two-year clinical and radiographic outcomes.

Weinstein M, Ayala G, Roura R, Christmas K, Warren D, Simon P N Am Spine Soc J. 2023; 16:100286.

PMID: 38025939 PMC: 10652136. DOI: 10.1016/j.xnsj.2023.100286.

Expandable vs Static Interbody Devices for Lateral Lumbar Interbody Fusion.

Zakko P, Whaley J, Preston G, Park D Int J Spine Surg. 2022; 16(S1):S53-S60.

PMID: 35387889 PMC: 9983557. DOI: 10.14444/8236.

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