SURG-30. Carbon fiber–reinforced polyetheretherketone implants in spine oncology: a single-center study on safety, practicality, and postoperative care

Abstract BACKGROUND Carbon fiber–reinforced polyetheretherketone (CFRP) implants are gaining attention in spinal oncology due to their radiolucency, which enhances postoperative imaging and facilitates precise radiotherapy planning. However, real-world data on their clinical impact on postoperative management remains limited. This observational study aimed to evaluate the practical use of CFRP spinal implants in patients with primary and metastatic spinal tumors. The goal was to assess their clinical feasibility, safety, and contribution to imaging-based follow-up and adjuvant therapy planning. METHODS A retrospective chart review was conducted on patients treated with CFRP instrumentation for spinal tumors at a tertiary care center between 2022 and 2025. Collected data included patient demographics, surgical details, postoperative outcomes, and use of adjuvant therapies. RESULTS Forty-five patients were included, with 19 diagnosed with primary spinal tumors and the remainder with metastatic tumors. All patients underwent decompression with instrumentation, and cage placement was performed in 17 patients (37.8%). The median span of instrumentation covered five levels (IQR 3–7). The mean clinical follow-up was 14.6±13.9 months. At final follow-up, neurological function improved or remained stable in 42 patients (93.3%) compared to their preoperative baseline. Three patients underwent revision procedures. No intraoperative hardware failures or delayed implant-related complications necessitating revision occurred. Postoperative MRI was obtained in 43 patients (95.6%). Fifteen patients (33.3%) received adjuvant radiotherapy. MRI was used for treatment planning in 6 cases (40%), while 9 (60%) relied solely on CT. Two patients (4.4%) experienced local recurrence, with a median time to recurrence of 9.5 months. CONCLUSIONS CFRP spinal implants provide a safe and effective alternative to traditional titanium instruments, offering additional advantages in imaging and radiotherapy planning. Nonetheless, inconsistent adjuvant care practices limit the full realization of these benefits. Standardized protocols and studies involving larger cohorts with extended follow-up are needed to validate their long-term value.