Expandable polyaryl-ether-ether-ketone spacers for interbody distraction in the lumbar spine

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

Research output: Contribution to journalArticle

9 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)169-177
Number of pages9
JournalGlobal Spine Journal
Volume5
Issue number3
DOIs
StatePublished - Jun 20 2015

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Ketones
Ether
Spine
Visual Analog Scale
Buttocks
Leg
Equipment and Supplies
Lordosis
Retrospective Studies
Transplants

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Alimi, M., Shin, B., MacIelak, M., Hofstetter, C. P., Njoku, I., Tsiouris, A. J., ... Härtl, R. (2015). Expandable polyaryl-ether-ether-ketone spacers for interbody distraction in the lumbar spine. Global Spine Journal, 5(3), 169-177. https://doi.org/10.1055/s-0035-1552988
Alimi, Marjan ; Shin, Benjamin ; MacIelak, Michael ; Hofstetter, Christoph P. ; Njoku, Innocent ; Tsiouris, Apostolos J. ; Elowitz, Eric ; Härtl, Roger. / Expandable polyaryl-ether-ether-ketone spacers for interbody distraction in the lumbar spine. In: Global Spine Journal. 2015 ; Vol. 5, No. 3. pp. 169-177.
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title = "Expandable polyaryl-ether-ether-ketone spacers for interbody distraction in the lumbar spine",
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.",
author = "Marjan Alimi and Benjamin Shin and Michael MacIelak and Hofstetter, {Christoph P.} and Innocent Njoku and Tsiouris, {Apostolos J.} and Eric Elowitz and Roger H{\"a}rtl",
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Alimi, M, Shin, B, MacIelak, M, Hofstetter, CP, Njoku, I, Tsiouris, AJ, Elowitz, E & Härtl, R 2015, 'Expandable polyaryl-ether-ether-ketone spacers for interbody distraction in the lumbar spine', Global Spine Journal, vol. 5, no. 3, pp. 169-177. https://doi.org/10.1055/s-0035-1552988

Expandable polyaryl-ether-ether-ketone spacers for interbody distraction in the lumbar spine. / Alimi, Marjan; Shin, Benjamin; MacIelak, Michael; Hofstetter, Christoph P.; Njoku, Innocent; Tsiouris, Apostolos J.; Elowitz, Eric; Härtl, Roger.

In: Global Spine Journal, Vol. 5, No. 3, 20.06.2015, p. 169-177.

Research output: Contribution to journalArticle

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T1 - Expandable polyaryl-ether-ether-ketone spacers for interbody distraction in the lumbar spine

AU - Alimi, Marjan

AU - Shin, Benjamin

AU - MacIelak, Michael

AU - Hofstetter, Christoph P.

AU - Njoku, Innocent

AU - Tsiouris, Apostolos J.

AU - Elowitz, Eric

AU - Härtl, Roger

PY - 2015/6/20

Y1 - 2015/6/20

N2 - 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.

AB - 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.

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