About 30% of all cancer patients will develop bone metastases and the spine is affected in approximately 70% of these patients. For spinal cancer treatment, radiation therapy plays an important role in pain management, the local treatment of spinal tumors and the prevention of pathologic fractures. Before administering radiation therapy, the radiologist relies on accurate CT or MRI images to plan the radiation dose. However, when state-of-the-art spinal implants made from metal are present, these implants cause artifacts on the planning images (Fig 1, left). Such metal artifacts make it more difficult to delineate anatomic structures during radiation therapy planning and correctly calculate the proper dose distributions. During radiation therapy, metal spinal implants may also shield remaining tumor cells from the curing radiation. In addition, metal implants induce scattering of the radiation beams into the surrounding soft tissue potentially causing side effects. Especially for proton-therapy, a lifesaving therapy for primary tumors, there is a high likelihood of patients being refused from therapy due to the presence of spinal implants made from metal.Here, radiolucent, non-metallic Carbon/PEEK composite implants offer a true solution (Fig 1, right).
icotec, a Swiss company, has become a leader in the design and manufacturing of high strength composite implant solutions made from Carbon/PEEK. The Carbon/PEEK material is composed of endless carbon fibers (about 55% vol) in a PEEK matrix (balance). During icotec’s proprietary composite flow molding (CFM) process, Carbon/PEEK pre-forms are shaped into the final component design without cutting the fibers. Even the manufacturing of threads is possible without further machining. This allows a combination of high strength properties with complex/small design features. As a result of the latest product development, the company introduced a Carbon/PEEK pedicle screw system, first of its kind in the world (Fig 2).
Meanwhile, the pedicle screw system is preferentially used by tumor surgeons across Europe to stabilize the spine of their patients without compromising subsequent tumor therapy.