A CARBON-FIBER-REINFORCED POLYMER CAGE FOR VERTEBRAL BODY REPLACEMENT- TECHNICAL NOTE

OBJECTIVE: We analyzed the surgical technique used for the replacement of damaged vertebral bodies of the thoracolumbar spine and the carbon fiber reinforced polymer (CFRP) cages that are used to replace the pa thological vertebral bodies. We also evaluated the biomechanical prope rties of carbon composite materials used in spinal surgery. TECHNIQUE: The surgical technique of CFRP implants may be divided into two disti nct steps, i.e., assembling the components that will replace the patho logical vertebral bodies and connecting the cage to an osteosynthetic system to immobilize the cage. INSTRUMENTATION: The CFRP cages, made o f Ultrapek polymer and AS-4 pyrolytic carbon fiber (AcroMed, Rotterdam , The Netherlands), are of different sizes and may be placed one on to p of the other and fixed together with a titanium rod. These component s ape hollow to allow fragments of bone to be pressed manually into th em and present threaded holes at 15, 30, and 90 degrees on the externa l surface, permitting the insertion of screws to connect the cage to a n anterior or posterior osteosynthetic system. RESULTS: To date, we ha ve used CFRP cages in 13 patients undergoing corporectomies and 10 pat ients undergoing spondylectomies. None of our patients have reported c omplications. CONCLUSIONS: CFRP implants offer several advantages comp ared with titanium or surgical grade stainless steel implants, demonst rating high versatility and outstanding biological and mechanical prop erties. Furthermore, CFRP implants are radiolucent and do not hinder r adiographic evaluation of bone fusion, allowing for better follow-up s tudies.