title: Safety and efficacy of polyetheretherketone (PEEK) cages in combination with posterior pedicel screw fixation in pyogenic spinal infection.
abstract: To date, there is growing consensus that PEEK material may be used for interbody fusion in spinal infections. Data supporting that claim are however restricted to a few very small clinical series. The aim of this study is to evaluate the outcome of surgical treatment of pyogenic spinal infections with PEEK cages in combination with posterior pedicel screw fixation.
  
  
  
  Between 2006 and 2013, a total of 211 patients suffering from spondylodiscitis underwent surgical debridement and instrumentation. There were 52 cases where PEEK cages were used. Laboratory and physical examinations were assessed at a 3-month follow-up. Last follow-up was performed with at a minimum of 12 months after surgery via a telephone interview.
  
  
  
  Mean age at presentation was 67 years, with 19 (37 %) male patients and 33 (63 %) female. Distribution of the infection was lumbar in 29 (56 %%), thoracic in 3 (6 %) and cervical in 11 (21 %) cases. Nine patients (17 %) had concomitant non-contiguous spondylodiscitis. Epidural abscess was found in 17 patients (33 %); 48 (92 %%) had pain; neurological deficits were found in 20 patients (38 %). All patients in this series underwent surgical debridement with instrumentation of the spine. Postoperative intravenous antibiotics were administered for 15.4 ± 6.8 days followed by 2.9 ± 0.5 months of oral antibiotics. Complete resolution of the infection was achieved in all cases. Of the 28 patients with neurological deficits, 6 had full recovery and 10 had improved incompletely after surgery. One patient suffered from a pulmonary embolism postoperatively. There were no mortalities.
  
  
  
  Use of PEEK cages for interbody fusion is feasible and safe in patients suffering from a pyogenic spinal infection.
authors: Neurochirurgische Klinik und Poliklinik, Technische Universität München, Klinikum rechts der Isar, München, Germany. ehab.shiban@tum.de.|Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. ehab.shiban@tum.de.
authors: Ehab
authors: 0000-0001-7427-3034
authors: E
authors: Shiban
authors: Neurochirurgische Klinik und Poliklinik, Technische Universität München, Klinikum rechts der Isar, München, Germany.
authors: Insa
authors: I
authors: Janssen
authors: Serviço de Neurocirurgia, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal.
authors: Pedro Ribeiro
authors: PR
authors: da Cunha
authors: Neurochirurgische Klinik und Poliklinik, Technische Universität München, Klinikum rechts der Isar, München, Germany.
authors: Jessica
authors: J
authors: Rainer
authors: Neurochirurgische Klinik und Poliklinik, Technische Universität München, Klinikum rechts der Isar, München, Germany.|Klinik für Neurochirurgie, Helios Kliniken, Krefeld, Germany.
authors: Michael
authors: M
authors: Stoffel
authors: Neurochirurgische Klinik und Poliklinik, Technische Universität München, Klinikum rechts der Isar, München, Germany.
authors: Jens
authors: J
authors: Lehmberg
authors: Neurochirurgische Klinik und Poliklinik, Technische Universität München, Klinikum rechts der Isar, München, Germany.|Neurochirurgische Klinische und Poliklinik, Universitätsklinikum Mainz, Mainz, Germany.
authors: Florian
authors: F
authors: Ringel
authors: Neurochirurgische Klinik und Poliklinik, Technische Universität München, Klinikum rechts der Isar, München, Germany.
authors: Bernhard
authors: B
authors: Meyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001577:Benzophenones; D003646:Debridement / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D015299:Discitis / Q000601:surgery*; D020802:Epidural Abscess / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007659:Ketones / Q000009:adverse effects / Q000627:therapeutic use; D008161:Lumbosacral Region / Q000601:surgery; D008297:Male; D008875:Middle Aged; D065289:Pedicle Screws / Q000009:adverse effects*; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use; D011108:Polymers; D011183:Postoperative Complications / Q000188:drug therapy*; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001577:Benzophenones; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols
keywords: Instrumentation; Interbody fusion; PEEK; Spondylodiscitis; Surgery