Abstract
The study investigated whether the use of carbon fiber-reinforced PEEK screw material (CF-PEEK) can reduce magnetic resonance imaging (MRI) artifact formation. Two consecutive groups of patients were treated for degenerative spinal disorders of the lumbar spine with dorsal transpedicular spinal fusion. The first group (n = 27) received titanium pedicle screws. The second group (n = 20) received CF-PEEK screws. All patients underwent an MRI assessment within the first four postoperative weeks. For each operated segment, the surface of the artifact-free vertebral body area was calculated as percentage of the total vertebral body. For each implanted segment, the assessability of the spinal canal, the neuroforamina, and the pedicle screws, as well as the surrounding bony and soft-tissue structures was graded from 1 to 5. A mean artifact-free vertebral body area of 48.3 ± 5.0% was found in the in the titanium group and of 67.1 ± 5.6% in the CF-PEEK group (p ≤ 0.01). Assessability of the lumbar spine was significantly improved for CF-PEEK screws (p ≤ 0.01) for all measurements. CF-PEEK pedicle screws exhibit smaller artifact areas on vertebral body surfaces and their surrounding tissues, which improves the radiographic assessability. Hence, CF-PEEK may provide a diagnostic benefit.
Highlights
The study investigated whether the use of carbon fiber-reinforced PEEK screw material (CF-PEEK) can reduce magnetic resonance imaging (MRI) artifact formation
For the analysis of artifact-free vertebral body surfaces, one caudal vertebral body (1.8%) in the titanium pedicle screw group and one caudal vertebral body in the CF-PEEK group were excluded from the analysis due to insufficient quality of the MRI images
The main finding of the study was that the use of CF-PEEK pedicle screws results in a substantial reduction of MR artifact areas on vertebral surfaces, which significantly improved the postoperative assessability of anatomical structures through MRI after lumbar spondylodesis, and provides a substantial diagnostic benefit
Summary
The study investigated whether the use of carbon fiber-reinforced PEEK screw material (CF-PEEK) can reduce magnetic resonance imaging (MRI) artifact formation. The assessability of the spinal canal, the neuroforamina, and the pedicle screws, as well as the surrounding bony and soft-tissue structures was graded from 1 to 5. Artifacts on MRI may lead to incorrect diagnosis, with potential serious consequences on patients’ health and o utcomes[4,5] Methods such as Slice Encoding for Metal Artifact Correction (SEMAC)[6] and Multi-Acquisition Variable Resonance Image Combination (MAVRIC)[7] may improve image quality and decrease the extent of metal artifact, the utility of these methods as an appropriate diagnostic tool in symptomatic patients with metal implants still needs to be established[3]. A previously conducted study found that postoperative CT and MRI scans show reduced artifacts in patients who received CF-PEEK pedicle screws for the treatment of spinal tumors, when compared with standard titanium alloy implants[9]. The aim of the study was to assess whether the use of CF-PEEK material can reduce MRI artifact formation and improve the assessability of important anatomical structures on imaging
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