PEEK-Halo effect in interbody fusion
PEEK-Halo effect in interbody fusion
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DOI：
10.1016/j.jocn.2015.07.017
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发表时间：
2016-02-01
影响因子：
2
通讯作者：
Mobbs, Ralph J.
中科院分区：
文献类型：
--
作者：
Phan, Kevin;Hogan, Jarred A.;Mobbs, Ralph J.
最近的发展已经看到聚[芳基醚醚酮]（PEEK）越来越多地用于椎体融合。改进PEEK的更新颖的方法包括引入钛PEEK（Ti-PEEK）复合材料和涂层。本文旨在描述PEEK基植入物的潜在并发症，该并发症与周围骨结合较差有关，产生了在Ti-PEEK复合植入物中未观察到的“PEEK-Halo”效应。我们展示了两名接受前路腰椎椎间融合术（ALIF）的患者的图像。第1例患者使用PEEK植入物接受L5/S1 ALIF，而第2例患者使用Ti-PEEK复合植入物接受L4/L5 ALIF。使用CT成像寻找骨整合的证据，并使用羊胫骨模型的组织学制备物进行确认。PEEK-光晕效应通过CT成像上PEEK植入物和植骨之间的光晕效应来证明。这种现象继发于PEEK植入物的骨结合不良。在接受Ti-PEEK复合移植物的第二例患者中未证实PEEK-Halo效应。羊模型中PEEK与Ti-PEEK植入物的移植物/骨界面的组织学分析进一步证实PEEK植入物的骨结合较差。总之，PEEK-Halo效应继发于PEEK植入物插入后相邻椎体终板处PEEK的最小骨整合。在Ti-PEEK植入物中未观察到这种效应，这可能支持钛在改善PEEK基质骨-植入物界面方面的作用。(C)2015爱思唯尔有限公司版权所有。
Recent developments have seen poly[aryl-ether-ether-ketone] (PEEK) being increasingly used in vertebral body fusion. More novel approaches to improve PEEK have included the introduction of titanium PEEK (Ti-PEEK) composites and coatings. This paper aims to describe a potential complication of PEEK based implants relating to poorer integration with the surrounding bone, producing a "PEEK-Halo" effect which is not seen in Ti-PEEK composite implants. We present images from two patients undergoing anterior lumbar interbody fusion (ALIF). The first patient underwent an L5/S1 ALIF using a PEEK implant whilst the second patient underwent L4/L5 ALIF using a Ti-PEEK composite implant. Evidence of osseointegration was sought using CT imaging and confirmed using histological preparations of a sheep tibia model. The PEEK-Halo effect is demonstrated by a halo effect between the PEEK implant and the bone graft on CT imaging. This phenomenon is secondary to poor osseointegration of PEEK implants. The PEEK-Halo effect was not demonstrated in the second patient who received a Ti-PEEK composite graft. Histological analysis of graft/bone interface surfaces in PEEK versus Ti-PEEK implants in a sheep model further confirmed poorer osseointegration of the PEEK implant. In conclusion, the PEEK-Halo effect is seen secondary to minimal osseointegration of PEEK at the adjacent vertebral endplate following a PEEK implant insertion. This effect is not seen with Ti-PEEK implants, and may support the role of titanium in improving the bone-implant interface of PEEK substrates. (C) 2015 Elsevier Ltd. All rights reserved.