Display options
Share it on

Global Spine J. 2015 Jun;5(3):169-78. doi: 10.1055/s-0035-1552988.

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

Global spine journal

Marjan Alimi, Benjamin Shin, Michael Macielak, Christoph P Hofstetter, Innocent Njoku, Apostolos J Tsiouris, Eric Elowitz, Roger Härtl

Affiliations

  1. Weill Cornell Brain and Spine Center, Department of Neurological Surgery, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York, United States.
  2. Department of Neuroradiology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York, United States.

PMID: 26131383 PMCID: PMC4472284 DOI: 10.1055/s-0035-1552988

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.

Keywords: Oswestry Disability Index; disc height; expandable PEEK cage; graft subsidence; interbody fusion; lumbar lordosis; lumbar spine; visual analog scale

References

  1. Spine J. 2007 Sep-Oct;7(5):541-6 - PubMed
  2. Pain. 2000 Dec 1;88(3):287-94 - PubMed
  3. J Spinal Disord Tech. 2013 Apr;26(2):87-92 - PubMed
  4. Spine (Phila Pa 1976). 1995 May 1;20(9):1017-28 - PubMed
  5. Neurosurg Focus. 2006 Mar 15;20(3):E6 - PubMed
  6. J Bone Joint Surg Am. 2008 Sep;90(9):1839-47 - PubMed
  7. Biomaterials. 2006 Jan;27(3):324-34 - PubMed
  8. Neurosurgery. 2013 Apr;72 (4):529-39; discussion 528-9 - PubMed
  9. Spine (Phila Pa 1976). 2012 Jan 15;37(2):E79-85 - PubMed
  10. Neurosurgery. 2011 Apr;68(4):897-902; discussion 902 - PubMed
  11. Arch Orthop Trauma Surg. 2011 Jun;131(6):791-6 - PubMed
  12. Clin Orthop Relat Res. 2013 May;471(5):1406-11 - PubMed
  13. Spine J. 2003 Jul-Aug;3(4):301-9 - PubMed
  14. Eur Spine J. 2003 Feb;12(1):12-20 - PubMed
  15. Clin Orthop Relat Res. 2002 Jan;(394):73-83 - PubMed
  16. Phys Ther. 2001 Feb;81(2):776-88 - PubMed
  17. J Spinal Disord Tech. 2012 Apr;25(2):116-22 - PubMed
  18. Pain. 2001 Nov;94(2):149-58 - PubMed
  19. Biomaterials. 2007 Nov;28(32):4845-69 - PubMed

Publication Types