Suitability of carbon fiber-reinforced polyetheretherketone cages for use as anterior struts following corpectomy

Abstract

OBJECTIVE: Fibular allograft remains a widely used strut for corpectomy surgeries. The amount of graft material that can be packed into an allograft strut has not been quantifed. Cages are an alternative to fibular allograft for fusion surgeries. The authors of this study assessed the suitability of carbon fiber-reinforced polyetheretherketone (CFRP) cages for anterior corpectomy surgeries. They further explored the parameters known to affect fusion rates in clinical practice. METHODS: Six fibular allografts were tested at standard lengths. Three sets of carbon fiber cages (Bengal, DePuy Spine), each with a different footprint size but the same lengths, were tested. The allografts and cages were wrapped in adhesive, fluid-tight transparent barriers and filled with oil. The volume and weight of the oil instilled as well as the implant footprints were measured. The fibular allografts and cages were tested at 20-, 40-, and 50-mm lengths. Two investigators independently performed all measurements 5 times. Five CFRP cubes (1 × 1 × 1 cm) were tested under pure compression, and load versus displacement curves were plotted to determine the modulus of elasticity. RESULTS: Significantly more oil fit in the CFRP cages than in the fibular allografts (p < 0.0001). The weight and volume of oil was 4-6 times greater in the cages. Interobserver (r = 0.991) and intraobserver (r = 0.993) reliability was excellent. The modulus of elasticity for CFRP was 16.44 ± 2.07 GPa. CONCLUSIONS: Carbon fber-reinforced polyetheretherketone cages can accommodate much more graft material than can fibular allografts. In clinical practice, the ability to deliver greater amounts of graft material following a corpectomy may improve fusion rates.