Radiolucent carbon fibre pedicle screws in non-oncologic spinal surgery: A clinical series of 11 patients

Metal pedicle screws, particularly titanium, can cause significant imaging artifacts and may lead to stress shielding. Carbon fibre–reinforced polyetheretherketone (CFR-PEEK) pedicle screws offer radiolucency and a more bone-like modulus of elasticity, potentially improving postoperative imaging and reducing implant-related complications in non-oncologic spinal surgery. To evaluate the clinical and radiographic outcomes of CFR-PEEK pedicle screws in a series of non-oncologic spinal surgeries, covering degenerative disease in the setting of osteoporosis, trauma, and revision for non-union. We retrospectively reviewed 11 consecutive patients who underwent CFR-PEEK pedicle screw fixation at a single institution for non-oncologic spinal pathology between June 6, 2022, and July 8, 2024. Data included patient demographics, surgical approach, radiographic fusion and complications. Mean age was 60 years, with 4 cases for revision of non-union, 4 cases for degenerative disease, and 3 for spinal cord compression and/or trauma. Postoperative imaging confirmed improved clarity of bony anatomy and neural structures due to the screws’ radiolucency, and all patients achieved fusion at final follow-up. There have been no implant-related complications in any patient at the time of this writing. CFR-PEEK pedicle screws provided satisfactory stabilisation in this series of 11 non-oncologic cases, enabling clearer postoperative imaging and offering a theoretical advantage in reducing stress shielding. No patient has required revision to date, although future complications cannot be excluded. If adjacent segment pathology were to necessitate additional fusion, the biomechanical implications of extending constructs with existing carbon-based screws remain uncertain and warrant further study. Larger prospective trials are needed to validate these findings and define optimal patient selection.