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Advances in Radiotherapy
& Nuclear Medicine CFR-PEEK: A systematic review

Table 2. (Continued)
Article Number Male: Mean Type of Types of cancer Area of Titanium Anterior Total number of
of Female age study spine control reconstruction CFR‑PEEK screws
patients ratio (years) (Y/N) (Y/N) placed
Alverez- 69 47:22 56.1 Retrospective Renal cell carcinoma (12) C: 0 N N 491
Brekenridge Lung (6) CT: 0
et al.,2023 16 Chondrosarcoma (5) T: 55
Sarcoma (3) TL: 0
Chordoma (1) L: 14
Epitheloid fibrosarcoma (1) LS: 0
Ewing sarcoma (1)
Giant cell (1)
Lwiomyosarcoma (1)
Myxoid liposarcoma (1)
Osteoblastoma (1)
Osteochondroma (1)
Recurrent solitary fibrous
tumor (1)
Sarcomatoid tumor (1)
Schwannoma (1)
Aneurysmal bone cyst (1)
Myeloma (1)
Undifferentiated
pleomorphic sarcoma (1)
Thyroid (4)
Colon (3)
Prostate (3)
Esophageal carcinoma (2)
Melanoma (2)
Paraganglioma (2)
Breast (2)
CUP (2)
Adrenal carcinoma (2)
Anal carcinoma (1)
Cholangiocarcinoma (1)
HCC (1)
Malignant thymoma (1)
Pheochromocytoma (1)
SCCT (1)
Teratoma (1)
Abbreviations: HCC: Hepatocellular carcinoma; CUP: Cancer of unknown primary origin; GI: Gastrointestinal; RCC: Renal cell carcinoma;
SCCT: Squamous cell carcinoma of thyroid; SCLC: Small cell lung cancer; NSCLC: Non-small cell lung cancer; CFR-PEEK: Carbon fiber-reinforced
polyetheretherketone; C: Cervical; CT: Cervicothoracic; T: Thoraic; TL: Thoracolumbar; L: Lumbar; LS: Lumbosacral.

prevalent were epidural hematomas (7 of the 28 events), as shown in Table 4. Cofano et al. showed that CFR-PEEK
cement-related complications (8 of the 28 events), screws demonstrated non-inferiority in complication rates
and pneumonia/pleural effusion (6 of the 28 events). compared to titanium screws. Tedesco et al. also showed
5
Altogether, these complications occurred in 5.86% that complication rates were comparable between the
(28/478) of patients (95% CI, 3.98 – 7.74), and were groups and demonstrated the similarity between CFR-
discussed in 4 of the 9 studies. 5,10-12
PEEK and titanium in terms of stability, weight-bearing, and
4. Discussion functional recovery. The distinctions between titanium
13
and CFR-PEEK are centered around cost and imaging
CFR-PEEK and titanium are the two main materials
used for surgical fixation in the management of spinal artifact (CT/MRI). Titanium screws are significantly less
metastatic disease, each presenting unique advantages and expensive than CFR-PEEK, but CFR-PEEK allows for
limitations. Four of the major comparisons between these better postoperative imaging via CT and MRI due to less
9
two entities are cost, complication rate, imaging artifact artifact. Figure 2 demonstrates visualization of CFR-PEEK
(CT/magnetic resonance imaging [MRI]), and durability, hardware on postoperative X-ray, CT, and MRI.

Volume 2 Issue 2 (2024) 7 doi: 10.36922/arnm.3130