{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:43:15Z","timestamp":1785422595786,"version":"3.56.0"},"reference-count":64,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Carbon fiber\u2013reinforced polyetheretherketone (CFR-PEEK) instrumentation is increasingly being used in patients with spine tumors as the body of literature supporting its benefit in local disease surveillance and radiation planning grows. Small single-institution experiences with short-term follow-up have yet to demonstrate issues with construct durability despite different biomechanical properties of CFR-PEEK compared to titanium. In this study the authors evaluated CFR-PEEK hardware failures in patients with surgically treated spine tumors who had long-term follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This is an IRB-approved retrospective cohort study of patients with spine tumors who underwent instrumented spinal fusion with CFR-PEEK or titanium instrumentation at a single tertiary care center. Inclusion criteria were as follows: 1) age &gt; 18 years; 2) pedicle screw fixation with CFR-PEEK or titanium; and 3) minimum 6 months of follow-up. The surgical indication was reviewed and agreed upon at a multidisciplinary spine tumor board meeting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 190 patients undergoing CFR-PEEK instrumentation were identified during the study period; 148 had at least a 6-month follow-up. Of those 148, the median follow-up was 13.7 months. In total, there were 861 CFR-PEEK pedicle screws, 266 CFR-PEEK spinal rods, and 15 CFR-PEEK corpectomy cages included in the study. Percutaneous CFR-PEEK instrumentation was performed in 13 cases. There were 6 (4.1%) CFR-PEEK cases of mechanical\/hardware failure, with a median interval time to failure of 5.51 (range 2.74\u20139.38) months. There were no hardware-related complications in the 26 patients who received CFR-PEEK instrumentation and who had a &gt; 24-month follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>This institutional experience provides the largest cohort with long-term follow-up to evaluate CFR-PEEK\u2013related instrumentation failure in patients with spine tumors. The rate of hardware failure among CFR-PEEK instrumented constructs was comparable to that in the current literature for titanium implants used in degenerative spine and spine oncology treatment. Importantly, there were no hardware failures noted among patients with extended long-term survival, reinforcing the durability of CFR-PEEK instrumentation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.2.focus24976","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T06:39:50Z","timestamp":1746081590000},"page":"E10","source":"Crossref","is-referenced-by-count":7,"title":["Durability of carbon fiber\u2013reinforced PEEK spinal instrumentation in spine oncology: a single-institution longitudinal experience"],"prefix":"10.3171","volume":"58","author":[{"given":"Mark","family":"Damante","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth B.","family":"Wilson","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Ward","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kofi","family":"Mensah-Arhin","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivam","family":"Gandhi","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anas","family":"Bardeesi","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Xu","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Palmer","sequence":"additional","affiliation":[{"name":"Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Bradley","family":"Elder","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram B.","family":"Chakravarthy","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Global Spine J","first-page":"249","article-title":"Strategy in the surgical treatment of primary spinal tumors","volume":"2","author":"Williams R","year":"2012","unstructured":"Williams R, Foote M, Deverall H. Strategy in the surgical treatment of primary spinal tumors. Global Spine J. 2012;2(4):249\u2013266."},{"issue":"22)(suppl","key":"b2","first-page":"S101","article-title":"Shifting paradigms in the treatment of metastatic spine disease","volume":"34","author":"Bilsky MH","year":"2009","unstructured":"Bilsky MH, Laufer I, Burch S. Shifting paradigms in the treatment of metastatic spine disease. Spine (Phila Pa 1976).2009;34(22)(suppl):S101\u2013S107."},{"key":"b3","series-title":"J Bone Oncol","first-page":"100320","article-title":"Separation surgery for metastatic epidural spinal cord compression: a qualitative review","volume":"25","author":"Di Perna G","year":"2020","unstructured":"Di Perna G, Cofano F, Mantovani C,  Separation surgery for metastatic epidural spinal cord compression: a qualitative review. J Bone Oncol. 2020;25:100320."},{"issue":"3","key":"b4","series-title":"J Neurooncol","first-page":"705","article-title":"Early versus late construct failure in spine metastatic disease: implications for surgical strategy and oncologic outcome","volume":"171","author":"Kreatsoulas D","year":"2025","unstructured":"Kreatsoulas D, George A, Kolawole S,  Early versus late construct failure in spine metastatic disease: implications for surgical strategy and oncologic outcome. J Neurooncol. 2025;171(3):705\u2013714."},{"issue":"1","key":"b5","series-title":"Tech Reg Anesth Pain Manag","first-page":"35","article-title":"Kyphoplasty for tumor-associated spinal fractures","volume":"9","author":"Vrionis FD","year":"2005","unstructured":"Vrionis FD, Hamm A, Stanton N, Sullivan M, Obadia M, Miguel RV. Kyphoplasty for tumor-associated spinal fractures. Tech Reg Anesth Pain Manag. 2005;9(1):35\u201339."},{"key":"b6","series-title":"J Clin Neurosci","first-page":"166","article-title":"Hardware failure in patients with metastatic cancer to the spine","volume":"45","author":"Pedreira R","year":"2017","unstructured":"Pedreira R, Abu-Bonsrah N, Karim Ahmed A,  Hardware failure in patients with metastatic cancer to the spine. J Clin Neurosci. 2017;45:166\u2013171."},{"issue":"3","key":"b7","series-title":"J Neurosurg Spine","first-page":"465","article-title":"Readmission after spinal epidural abscess management in urban populations: a bi-institutional study","volume":"32","author":"Longo M","year":"2019","unstructured":"Longo M, Pennington Z, Gelfand Y,  Readmission after spinal epidural abscess management in urban populations: a bi-institutional study. J Neurosurg Spine. 2019;32(3):465\u2013472."},{"issue":"2","key":"b8","series-title":"J Neurosurg Spine","first-page":"285","article-title":"Outcome analysis of surgery for symptomatic spinal metastases in long-term cancer survivors","volume":"31","author":"Barzilai O","year":"2019","unstructured":"Barzilai O, McLaughlin L, Lis E, Yamada Y, Bilsky MH, Laufer I. Outcome analysis of surgery for symptomatic spinal metastases in long-term cancer survivors. J Neurosurg Spine. 2019;31(2):285\u2013290."},{"issue":"9","key":"b9","series-title":"Spine J","first-page":"1850","article-title":"The incidence and patterns of hardware failure after separation surgery in patients with spinal metastatic tumors","volume":"14","author":"Amankulor NM","year":"2014","unstructured":"Amankulor NM, Xu R, Iorgulescu JB,  The incidence and patterns of hardware failure after separation surgery in patients with spinal metastatic tumors. Spine J. 2014;14(9):1850\u20131859."},{"key":"b10","series-title":"titanium. J Neurooncol","first-page":"155","article-title":"Impact of instrumentation material on local recurrence: a case-matched series using carbon fiber-PEEK vs","volume":"171","author":"Ward J","year":"2025","unstructured":"Ward J, Damante M, Wilson S,  Impact of instrumentation material on local recurrence: a case-matched series using carbon fiber-PEEK vs. titanium. J Neurooncol. 2025;171:155\u2013162."},{"issue":"8","key":"b11","series-title":"Eur Spine J","first-page":"1775","article-title":"Pedicle screw anchorage of carbon fiber-reinforced PEEK screws under cyclic loading","volume":"27","author":"Lindtner RA","year":"2018","unstructured":"Lindtner RA, Schmid R, Nydegger T, Konschake M, Schmoelz W. Pedicle screw anchorage of carbon fiber-reinforced PEEK screws under cyclic loading. Eur Spine J. 2018;27(8):1775\u20131784."},{"key":"b12","series-title":"J Clin Neurosci","first-page":"106","article-title":"Carbon fiber reinforced vs titanium implants for fixation in spinal metastases: a comparative clinical study about safety and effectiveness of the new \"carbon-strategy\"","volume":"75","author":"Cofano F","year":"2020","unstructured":"Cofano F, Di Perna G, Monticelli M,  Carbon fiber reinforced vs titanium implants for fixation in spinal metastases: a comparative clinical study about safety and effectiveness of the new \"carbon-strategy\". J Clin Neurosci. 2020;75:106\u2013111."},{"issue":"21","key":"b13","series-title":"Cancers (Basel)","first-page":"5275","article-title":"CFR-PEEK pedicle screw instrumentation for spinal neoplasms: a single center experience on safety and efficacy","volume":"14","author":"Joerger AK","year":"2022","unstructured":"Joerger AK, Seitz S, Lange N,  CFR-PEEK pedicle screw instrumentation for spinal neoplasms: a single center experience on safety and efficacy. Cancers (Basel). 2022;14(21):5275."},{"issue":"1","key":"b14","series-title":"Neurospine","first-page":"317","article-title":"Carbon fiber-reinforced polyetheretherketone spinal implants for treatment of spinal tumors: perceived advantages and limitations","volume":"20","author":"Alvarez-Breckenridge C","year":"2023","unstructured":"Alvarez-Breckenridge C, de Almeida R, Haider A,  Carbon fiber-reinforced polyetheretherketone spinal implants for treatment of spinal tumors: perceived advantages and limitations. Neurospine. 2023;20(1):317\u2013326."},{"issue":"2","key":"b15","series-title":"Adv Radiother Nucl Med","first-page":"3130","article-title":"Emerging role of carbon fiber-reinforced polyetheretherketone instrumentation in spinal oncology: a systematic review","volume":"2","author":"Ward J","year":"2024","unstructured":"Ward J, Wilson S, Eaton RG, Coelho V, Xu DS, Chakravarthy VB. Emerging role of carbon fiber-reinforced polyetheretherketone instrumentation in spinal oncology: a systematic review. Adv Radiother Nucl Med. 2024;2(2):3130."},{"issue":"2","key":"b16","series-title":"Pract Radiat Oncol","first-page":"e131","article-title":"Use of magnetic resonance imaging for postoperative radiation therapy planning in patients with carbon fiber-reinforced polyetheretherketone instrumentation","volume":"15","author":"Ward J","year":"2025","unstructured":"Ward J, Damante M, Wilson S,  Use of magnetic resonance imaging for postoperative radiation therapy planning in patients with carbon fiber-reinforced polyetheretherketone instrumentation. Pract Radiat Oncol. 2025;15(2):e131-e137"},{"key":"b17","series-title":"Version 29.0.1.0,","article-title":"Statistics for Windows","author":"SPSS","year":"2023","unstructured":"SPSS. Statistics for Windows. 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J Oncol. 2018;2018(1):6140381."},{"issue":"4","key":"b23","series-title":"Asian Spine J","first-page":"481","article-title":"Symptomatic construct failure after metastatic spine tumor surgery","volume":"15","author":"Kumar N","year":"2021","unstructured":"Kumar N, Patel R, Tan JH,  Symptomatic construct failure after metastatic spine tumor surgery. Asian Spine J. 2021;15(4):481\u2013490."},{"issue":"6","key":"b24","series-title":"Asian Spine J","first-page":"878","article-title":"Incidence and risk factors for implant failure in spinal metastasis surgery","volume":"14","author":"Wong YC","year":"2020","unstructured":"Wong YC, Chau WWJ, Kwok KO, Law SW. Incidence and risk factors for implant failure in spinal metastasis surgery. Asian Spine J. 2020;14(6):878\u2013885."},{"issue":"1","key":"b25","series-title":"J Orthop Surg Res","first-page":"110","article-title":"Factors associated with spinal fixation mechanical failure after tumor resection: a systematic review and meta-analysis","volume":"17","author":"Cai Z","year":"2022","unstructured":"Cai Z, Zhao Y, Tang X, Yang R, Yan T, Guo W. Factors associated with spinal fixation mechanical failure after tumor resection: a systematic review and meta-analysis. J Orthop Surg Res. 2022;17(1):110."},{"issue":"1","key":"b26","series-title":"Sci Rep","first-page":"2414","article-title":"Carbon-fiber reinforced PEEK instrumentation for spondylodiscitis: a single center experience on safety and efficacy","volume":"11","author":"Joerger AK","year":"2021","unstructured":"Joerger AK, Shiban E, Krieg SM, Meyer B. Carbon-fiber reinforced PEEK instrumentation for spondylodiscitis: a single center experience on safety and efficacy. Sci Rep. 2021;11(1):2414."},{"key":"b27","series-title":"N Am Spine Soc J","first-page":"100105","article-title":"Attitudes and trends in the use of radiolucent spinal implants: a survey of the North American Spine Society section of spinal oncology","volume":"10","author":"Zavras AG","year":"2022","unstructured":"Zavras AG, Schoenfeld AJ, Patt JC,  Attitudes and trends in the use of radiolucent spinal implants: a survey of the North American Spine Society section of spinal oncology. N Am Spine Soc J. 2022;10:100105."},{"issue":"6","key":"b28","series-title":"Acta Ortop Bras","first-page":"303","article-title":"Late failure of posterior fixation without bone fusion for vertebral metastases","volume":"23","author":"Bellato RT","year":"2015","unstructured":"Bellato RT, Teixeira WGJ, Torelli AG, Cristante AF, de Barros TE, de Camargo OP. Late failure of posterior fixation without bone fusion for vertebral metastases. 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J Neurosurg Spine. 2019;32(3):456\u2013464."},{"issue":"5","key":"b31","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Short-segment cement-augmented fixation in open separation surgery of metastatic epidural spinal cord compression: initial experience","volume":"50","author":"Newman WC","year":"2021","unstructured":"Newman WC, Amin AG, Villavieja J, Laufer I, Bilsky MH, Barzilai O. Short-segment cement-augmented fixation in open separation surgery of metastatic epidural spinal cord compression: initial experience. Neurosurg Focus. 2021;50(5):E11."},{"issue":"17","key":"b32","series-title":"Materials (Basel)","first-page":"2732","article-title":"Biomechanical study of a novel, expandable, non-metallic and radiolucent CF\/PEEK vertebral body replacement (VBR)","volume":"12","author":"Adler D","year":"2019","unstructured":"Adler D, Akbar M, Spicher A, Goerke SA, Schmoelz W. Biomechanical study of a novel, expandable, non-metallic and radiolucent CF\/PEEK vertebral body replacement (VBR). Materials (Basel). 2019;12(17):2732."},{"issue":"4","key":"b1","series-title":"Global Spine J","first-page":"249","article-title":"Strategy in the surgical treatment of primary spinal tumors","volume":"2","author":"Williams R","year":"2012","unstructured":"Williams R, Foote M, Deverall H. Strategy in the surgical treatment of primary spinal tumors. Global Spine J. 2012;2(4):249\u2013266."},{"issue":"22)(suppl","key":"b2","first-page":"S101","article-title":"Shifting paradigms in the treatment of metastatic spine disease","volume":"34","author":"Bilsky MH","year":"2009","unstructured":"Bilsky MH, Laufer I, Burch S. Shifting paradigms in the treatment of metastatic spine disease. Spine (Phila Pa 1976).2009;34(22)(suppl):S101\u2013S107."},{"key":"b3","series-title":"J Bone Oncol","first-page":"100320","article-title":"Separation surgery for metastatic epidural spinal cord compression: a qualitative review","volume":"25","author":"Di Perna G","year":"2020","unstructured":"Di Perna G, Cofano F, Mantovani C,  Separation surgery for metastatic epidural spinal cord compression: a qualitative review. J Bone Oncol. 2020;25:100320."},{"issue":"3","key":"b4","series-title":"J Neurooncol","first-page":"705","article-title":"Early versus late construct failure in spine metastatic disease: implications for surgical strategy and oncologic outcome","volume":"171","author":"Kreatsoulas D","year":"2025","unstructured":"Kreatsoulas D, George A, Kolawole S,  Early versus late construct failure in spine metastatic disease: implications for surgical strategy and oncologic outcome. J Neurooncol. 2025;171(3):705\u2013714."},{"issue":"1","key":"b5","series-title":"Tech Reg Anesth Pain Manag","first-page":"35","article-title":"Kyphoplasty for tumor-associated spinal fractures","volume":"9","author":"Vrionis FD","year":"2005","unstructured":"Vrionis FD, Hamm A, Stanton N, Sullivan M, Obadia M, Miguel RV. Kyphoplasty for tumor-associated spinal fractures. Tech Reg Anesth Pain Manag. 2005;9(1):35\u201339."},{"key":"b6","series-title":"J Clin Neurosci","first-page":"166","article-title":"Hardware failure in patients with metastatic cancer to the spine","volume":"45","author":"Pedreira R","year":"2017","unstructured":"Pedreira R, Abu-Bonsrah N, Karim Ahmed A,  Hardware failure in patients with metastatic cancer to the spine. J Clin Neurosci. 2017;45:166\u2013171."},{"issue":"3","key":"b7","series-title":"J Neurosurg Spine","first-page":"465","article-title":"Readmission after spinal epidural abscess management in urban populations: a bi-institutional study","volume":"32","author":"Longo M","year":"2019","unstructured":"Longo M, Pennington Z, Gelfand Y,  Readmission after spinal epidural abscess management in urban populations: a bi-institutional study. J Neurosurg Spine. 2019;32(3):465\u2013472."},{"issue":"2","key":"b8","series-title":"J Neurosurg Spine","first-page":"285","article-title":"Outcome analysis of surgery for symptomatic spinal metastases in long-term cancer survivors","volume":"31","author":"Barzilai O","year":"2019","unstructured":"Barzilai O, McLaughlin L, Lis E, Yamada Y, Bilsky MH, Laufer I. Outcome analysis of surgery for symptomatic spinal metastases in long-term cancer survivors. J Neurosurg Spine. 2019;31(2):285\u2013290."},{"issue":"9","key":"b9","series-title":"Spine J","first-page":"1850","article-title":"The incidence and patterns of hardware failure after separation surgery in patients with spinal metastatic tumors","volume":"14","author":"Amankulor NM","year":"2014","unstructured":"Amankulor NM, Xu R, Iorgulescu JB,  The incidence and patterns of hardware failure after separation surgery in patients with spinal metastatic tumors. Spine J. 2014;14(9):1850\u20131859."},{"key":"b10","series-title":"titanium. J Neurooncol","first-page":"155","article-title":"Impact of instrumentation material on local recurrence: a case-matched series using carbon fiber-PEEK vs","volume":"171","author":"Ward J","year":"2025","unstructured":"Ward J, Damante M, Wilson S,  Impact of instrumentation material on local recurrence: a case-matched series using carbon fiber-PEEK vs. titanium. 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Adv Radiother Nucl Med. 2024;2(2):3130."},{"issue":"2","key":"b16","series-title":"Pract Radiat Oncol","first-page":"e131","article-title":"Use of magnetic resonance imaging for postoperative radiation therapy planning in patients with carbon fiber-reinforced polyetheretherketone instrumentation","volume":"15","author":"Ward J","year":"2025","unstructured":"Ward J, Damante M, Wilson S,  Use of magnetic resonance imaging for postoperative radiation therapy planning in patients with carbon fiber-reinforced polyetheretherketone instrumentation. Pract Radiat Oncol. 2025;15(2):e131-e137"},{"key":"b17","series-title":"Version 29.0.1.0,","article-title":"Statistics for Windows","author":"SPSS","year":"2023","unstructured":"SPSS. Statistics for Windows. 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