{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:00Z","timestamp":1787755560565,"version":"build-2784847793"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:list list-type=\"plain\">\n                        <jats:list-item>\n                          <jats:p>\u00bb Traditional metallic implants used in spinal surgery, such as stainless steel, cobalt chrome, and titanium (Ti), can generate artifacts during magnetic resonance imaging and computed tomography, impeding visualization of the adjacent anatomy and impacting clinical decision-making.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\u00bb Carbon fiber\u2013reinforced polyether ether ketone (CFR-PEEK) spinal instrumentation is now commercially available. The reported benefits include minimal artifact with radiographic imaging while providing similar biomechanical properties when compared with traditional metallic implants.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\u00bb CFR-PEEK may be beneficial, following spinal separation surgery, by allowing more precise delivery of high-dose therapeutic radiation (stereotactic body radiation therapy) to the remaining tumor margins and avoid overdosing of the spinal cord.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\u00bb Long-term follow-up is needed to better understand the clinical durability of these newly available implants.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.rvw.26.00026","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T18:01:09Z","timestamp":1779300069000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Carbon Fiber Implants in Spine Surgery"],"prefix":"10.2106","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3840-6206","authenticated-orcid":false,"given":"Mahmoud N.","family":"Abu-Alkebash","sequence":"first","affiliation":[{"name":"Norton Letherman Spine Center, Louisville, Kentucky"},{"name":"Department of Orthopedic Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4197-4023","authenticated-orcid":false,"given":"Charles H.","family":"Crawford","sequence":"additional","affiliation":[{"name":"Norton Letherman Spine Center, Louisville, Kentucky"},{"name":"Department of Orthopedic Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5395-1649","authenticated-orcid":false,"given":"John R.","family":"Dimar","sequence":"additional","affiliation":[{"name":"Norton Letherman Spine Center, Louisville, Kentucky"},{"name":"Department of Orthopedic Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5488-9357","authenticated-orcid":false,"given":"Steven D.","family":"Glassman","sequence":"additional","affiliation":[{"name":"Norton Letherman Spine Center, Louisville, Kentucky"},{"name":"Department of Orthopedic Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2713-4304","authenticated-orcid":false,"given":"Andrew","family":"Windhorst","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7685-9036","authenticated-orcid":false,"given":"Leah Y.","family":"Carreon","sequence":"additional","affiliation":[{"name":"Norton Letherman Spine Center, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5]]},"reference":[{"issue":"14","key":"r1-20260520","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1097\/BRS.0000000000005356","article-title":"Carbon fiber versus titanium pedicle screws: a systematic review of radiologic, biomechanical, and clinical features","volume":"50","author":"Coan","year":"2025","journal-title":"Spine (Phila Pa 1976)"},{"issue":"3","key":"r2-20260520","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s00256-022-04069-7","article-title":"Carbon-fiber-reinforced polyetheretherketone orthopedic implants in musculoskeletal and spinal tumors: imaging and clinical features","volume":"52","author":"Long","year":"2023","journal-title":"Skeletal Radiol"},{"key":"r3-20260520","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.wneu.2021.05.032","article-title":"Radiotherapy and surgical advances in the treatment of metastatic spine tumors: a narrative review","volume":"151","author":"Porras","year":"2021","journal-title":"World Neurosurg"},{"key":"r4-20260520","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.wneu.2021.05.100","article-title":"Radiolucent carbon fiber-reinforced implants for treatment of spinal tumors-clinical, radiographic, and dosimetric considerations","volume":"152","author":"Takayanagi","year":"2021","journal-title":"World Neurosurg"},{"key":"r5-20260520","doi-asserted-by":"crossref","first-page":"105153","DOI":"10.1016\/j.clinbiomech.2020.105153","article-title":"Biomechanical effects of posterior pedicle screw-based instrumentation using titanium versus carbon fiber reinforced PEEK in an osteoporotic spine human cadaver model","volume":"80","author":"Oikonomidis","year":"2020","journal-title":"Clin Biomech (Bristol)"},{"key":"r7-20260520","first-page":"100844","article-title":"Novel carbon fiber pedicle screw system for the treatment of lumbar degenerative disc disease: results from a prospective, multicenter, FDA investigational device exemption study","volume":"25","author":"Miller","year":"2025","journal-title":"N Am Spine Soc J"},{"issue":"4","key":"r8-20260520","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1007\/s10143-020-01384-2","article-title":"Carbon fiber-reinforced PEEK versus titanium implants: an in vitro comparison of susceptibility artifacts in CT and MR imaging","volume":"44","author":"Kr\u00e4tzig","year":"2021","journal-title":"Neurosurg Rev"},{"issue":"1","key":"r9-20260520","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/s43465-024-01255-8","article-title":"Carbon fiber reinforced hybrid polyaryl-ether-ether-ketone (PEEK) spinal fixation system: technical features and preliminary clinical trial","volume":"59","author":"Behrbalk","year":"2024","journal-title":"Indian J Orthop"},{"issue":"8","key":"r10-20260520","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1007\/s00586-018-5538-8","article-title":"Pedicle screw anchorage of carbon fiber-reinforced PEEK screws under cyclic loading","volume":"27","author":"Lindtner","year":"2018","journal-title":"Eur Spine J"},{"key":"r11-20260520","doi-asserted-by":"crossref","first-page":"4796136","DOI":"10.1155\/2020\/4796136","article-title":"A novel spine fixation system made entirely of carbon-fiber-reinforced PEEK composite: an in vitro mechanical evaluation","volume":"2020","author":"Uri","year":"2020","journal-title":"Adv Orthop"},{"key":"r12-20260520","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.compositesb.2017.07.052","article-title":"Biomechanical evaluation of pedicle screw fixation system in spinal adjacent levels using polyetheretherketone, carbon-fiber-reinforced polyetheretherketone, and traditional titanium as rod materials","volume":"130","author":"Kang","year":"2017","journal-title":"Compos B Eng"},{"issue":"2","key":"r13-20260520","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.prro.2023.10.005","article-title":"Quantification of MRI artifacts in carbon fiber reinforced polyetheretherketone thoracolumbar pedicle screw constructs prior to spinal stereotactic radiosurgery","volume":"14","author":"de Almeida","year":"2024","journal-title":"Pract Radiat Oncol"},{"key":"r14-20260520","doi-asserted-by":"crossref","first-page":"e495","DOI":"10.1016\/j.wneu.2021.04.064","article-title":"The surgical treatment of pyogenic spondylodiscitis using carbon-fiber-reinforced polyether ether ketone implants: personal experience of a series of 81 consecutive patients","volume":"151","author":"Burkhardt","year":"2021","journal-title":"World Neurosurg"},{"issue":"1","key":"r15-20260520","doi-asserted-by":"crossref","first-page":"16094","DOI":"10.1038\/s41598-020-73386-5","article-title":"Carbon fiber-reinforced pedicle screws reduce artifacts in magnetic resonance imaging of patients with lumbar spondylodesis","volume":"10","author":"Fleege","year":"2020","journal-title":"Sci Rep"},{"key":"r16-20260520","doi-asserted-by":"crossref","first-page":"e155","DOI":"10.1016\/j.wneu.2022.06.135","article-title":"Qualitative assessment of titanium versus carbon fiber\/polyetheretherketone pedicle screw-related artifacts: a cadaveric study","volume":"166","author":"Kalasauskas","year":"2022","journal-title":"World Neurosurg"},{"issue":"3","key":"r17-20260520","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.spinee.2006.03.016","article-title":"Postimplantation MRI with cylindric and cubic intervertebral test implants: evaluation of implant shape, material, and volume in MRI artifacting: an in vitro study","volume":"7","author":"Ernstberger","year":"2007","journal-title":"Spine J"},{"issue":"2","key":"r18-20260520","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s00586-006-0064-5","article-title":"The interobserver-validated relevance of intervertebral spacer materials in MRI artifacting","volume":"16","author":"Ernstberger","year":"2007","journal-title":"Eur Spine J"},{"key":"r19-20260520","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.wneu.2023.01.090","article-title":"The use of carbon fiber-reinforced instrumentation in patients with spinal oncologic tumors: a systematic review of literature and future directions","volume":"173","author":"Perez-Roman","year":"2023","journal-title":"World Neurosurg"},{"issue":"1","key":"r20-20260520","doi-asserted-by":"crossref","first-page":"8","DOI":"10.21037\/jss-23-93","article-title":"The use of carbon fiber\/polyetheretherketone (CF\/PEEK) in pedicle screw fixation for spinal neoplasms-potential advantages in postoperative imaging and radiotherapy planning","volume":"10","author":"Ho","year":"2024","journal-title":"J Spine Surg"},{"issue":"1","key":"r21-20260520","doi-asserted-by":"crossref","first-page":"6700","DOI":"10.1038\/s41598-024-52498-2","article-title":"Evaluation of computed tomography artefacts of carbon-fiber and titanium implants in patients with spinal oligometastatic disease undergoing stereotactic ablative radiotherapy","volume":"14","author":"Rijs","year":"2024","journal-title":"Sci Rep"},{"issue":"4","key":"r22-20260520","doi-asserted-by":"crossref","first-page":"371","DOI":"10.2463\/mrms.mp.2015-0055","article-title":"Fat-suppressed MR imaging of the spine for metal artifact reduction at 3T: comparison of STIR and slice encoding for metal artifact correction fat-suppressed T2-weighted images","volume":"15","author":"Lee","year":"2016","journal-title":"Magn Reson Med Sci"},{"issue":"5","key":"r23-20260520","doi-asserted-by":"crossref","first-page":"2298","DOI":"10.3390\/tomography8050192","article-title":"Evaluating compressed SENSE (CS) MRI metal artifact reduction using pig L-spine phantom and transplant patients: focused on the CS-SEMAC (SPIR), mDixon(O-MAR) and STIR techniques","volume":"8","author":"Goo","year":"2022","journal-title":"Tomography"},{"issue":"10","key":"r24-20260520","doi-asserted-by":"crossref","first-page":"510","DOI":"10.5435\/JAAOS-D-24-01057","article-title":"Metal suppression magnetic resonance imaging techniques in orthopaedic and spine surgery","volume":"33","author":"Ziegeler","year":"2025","journal-title":"J Am Acad Orthop Surg"},{"key":"r25-20260520","first-page":"100608","article-title":"Enhanced strength and durability of long fiber type carbon fiber reinforced plastic rods over titanium alloy rods for spinal fixation","volume":"22","author":"Morita","year":"2025","journal-title":"N Am Spine Soc J"},{"issue":"4","key":"r26-20260520","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1007\/s00701-023-05502-z","article-title":"Clinical evaluation of vertebral body replacement of carbon fiber-reinforced polyetheretherketone in patients with tumor manifestation of the thoracic and lumbar spine","volume":"165","author":"Schwendner","year":"2023","journal-title":"Acta Neurochir (Wien)"},{"key":"r27-20260520","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.wneu.2017.04.091","article-title":"Radiolucent carbon fiber-reinforced pedicle screws for treatment of spinal tumors: advantages for radiation planning and follow-up imaging","volume":"105","author":"Ringel","year":"2017","journal-title":"World Neurosurg"},{"issue":"5","key":"r28-20260520","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.3171\/2025.2.FOCUS24976","article-title":"Durability of carbon fiber-reinforced PEEK spinal instrumentation in spine oncology: a single-institution longitudinal experience","volume":"58","author":"Damante","year":"2025","journal-title":"Neurosurg Focus"},{"issue":"21","key":"r29-20260520","doi-asserted-by":"crossref","first-page":"5275","DOI":"10.3390\/cancers14215275","article-title":"CFR-PEEK pedicle screw instrumentation for spinal neoplasms: a single center experience on safety and efficacy","volume":"14","author":"Joerger","year":"2022","journal-title":"Cancers (Basel)"},{"issue":"1","key":"r30-20260520","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1186\/s12891-025-08457-7","article-title":"Lumbar fusion using a carbon-fiber PEEK pedicle screw system combined with a carbon-fiber PEEK TLIF cage: a prospective, multicenter study","volume":"26","author":"Eif","year":"2025","journal-title":"BMC Musculoskelet Disord"},{"issue":"1","key":"r31-20260520","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s11060-024-04842-9","article-title":"Impact of instrumentation material on local recurrence: a case-matched series using carbon fiber-PEEK vs. titanium","volume":"171","author":"Ward","year":"2025","journal-title":"J Neurooncol"},{"key":"r32-20260520","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.jocn.2020.03.013","article-title":"Carbon fiber reinforced vs titanium implants for fixation in spinal metastases: a comparative clinical study about safety and effectiveness of the new \u201ccarbon-strategy\u201d","volume":"75","author":"Cofano","year":"2020","journal-title":"J Clin Neurosci"},{"issue":"4","key":"r33-20260520","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1007\/s00586-017-5258-5","article-title":"Carbon-fiber-reinforced PEEK fixation system in the treatment of spine tumors: a preliminary report","volume":"27","author":"Boriani","year":"2018","journal-title":"Eur Spine J"},{"issue":"5","key":"r34-20260520","doi-asserted-by":"crossref","first-page":"E13","DOI":"10.3171\/2021.2.FOCUS20995","article-title":"Carbon fiber-reinforced PEEK instrumentation in the spinal oncology population: a retrospective series demonstrating technique, feasibility, and clinical outcomes","volume":"50","author":"Neal","year":"2021","journal-title":"Neurosurg Focus"},{"issue":"5","key":"r35-20260520","doi-asserted-by":"crossref","first-page":"E11","DOI":"10.3171\/2025.2.FOCUS24995","article-title":"Evaluating long-term construct stability in metastatic spine cancer patients with carbon fiber-reinforced polyetheretherketone instrumentation","volume":"58","author":"Rosoklija","year":"2025","journal-title":"Neurosurg Focus"},{"key":"r36-20260520","doi-asserted-by":"crossref","first-page":"e536","DOI":"10.1016\/j.wneu.2021.07.092","article-title":"Cement-augmented carbon fiber-reinforced pedicle screw instrumentation for spinal metastases: safety and efficacy","volume":"154","author":"Wagner","year":"2021","journal-title":"World Neurosurg"},{"key":"r37-20260520","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.ejmp.2017.11.008","article-title":"Dosimetric characterization of carbon fiber stabilization devices for post-operative particle therapy","volume":"44","author":"Mastella","year":"2017","journal-title":"Phys Med"},{"issue":"24","key":"r38-20260520","doi-asserted-by":"crossref","first-page":"245031","DOI":"10.1088\/1361-6560\/ab8ba0","article-title":"Assessing the advantages of CFR-PEEK over titanium spinal stabilization implants in proton therapy: a phantom study","volume":"65","author":"Poel","year":"2020","journal-title":"Phys Med Biol"},{"key":"r39-20260520","doi-asserted-by":"crossref","first-page":"15330338221091700","DOI":"10.1177\/15330338221091700","article-title":"Comprehensive evaluation of carbon-fiber-reinforced polyetheretherketone (CFR-PEEK) spinal hardware for proton and photon planning","volume":"21","author":"Shi","year":"2022","journal-title":"Technol Cancer Res Treat"},{"key":"r40-20260520","doi-asserted-by":"crossref","first-page":"e749","DOI":"10.1016\/j.wneu.2022.05.043","article-title":"In situ real-time dosimetric studies for spine stereotactic body radiation therapy in a cadaver implanted with carbon-fiber and titanium instrumentation","volume":"164","author":"Zhang","year":"2022","journal-title":"World Neurosurg"},{"issue":"5","key":"r41-20260520","doi-asserted-by":"crossref","first-page":"615","DOI":"10.3171\/2024.10.SPINE24584","article-title":"Comparison of dosimetric variability in the cervical spine between carbon fiber and titanium instrumentation","volume":"42","author":"Mansi","year":"2025","journal-title":"J Neurosurg Spine"},{"issue":"3","key":"r42-20260520","first-page":"e2020057","article-title":"The advantages of carbon fiber based orthopedic devices in patients who have to undergo radiotherapy","volume":"91","author":"Soriani","year":"2020","journal-title":"Acta Biomed"},{"issue":"3","key":"r43-20260520","doi-asserted-by":"crossref","first-page":"323","DOI":"10.21037\/jss.2017.06.20","article-title":"Composite PEEK\/carbon fiber implants can increase the effectiveness of radiotherapy in the management of spine tumors","volume":"3","author":"Tedesco","year":"2017","journal-title":"J Spine Surg"},{"issue":"12","key":"r44-20260520","doi-asserted-by":"crossref","first-page":"3229","DOI":"10.1007\/s00586-020-06534-0","article-title":"Composite PEEK\/carbon fiber rods in the treatment for bone tumors of the cervical spine: a case series","volume":"29","author":"Boriani","year":"2020","journal-title":"Eur Spine J"},{"issue":"7","key":"r45-20260520","doi-asserted-by":"crossref","first-page":"872","DOI":"10.3390\/bioengineering10070872","article-title":"Carbon fiber-reinforced polyetheretherketone (CFR-PEEK) instrumentation in degenerative disease of lumbar spine: a pilot study","volume":"10","author":"Ghermandi","year":"2023","journal-title":"Bioengineering (Basel)"}],"container-title":["JBJS Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.RVW.26.00026","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:45:06Z","timestamp":1787751906000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.RVW.26.00026"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":44,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.rvw.26.00026","relation":{},"ISSN":["2329-9185"],"issn-type":[{"value":"2329-9185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}