Reasons for readmission need to be identified to better understand the differences observed here. Our multicenter study did not support the hypothesis that PEEK rods are associated with a lower ASD risk. No nonunions or 90-day complications were observed for the PEEK group 5 (2-year cumulative incidence = 0.7%) nonunions and 4 (1.3%) complications were observed for the Ti group.
A lower likelihood of readmission (OR = 0.34, 95% CI = 0.13-0.94) was observed following PEEK fusion compared with Ti. We did not observe a difference in risk for ASD (hazard ratio = 1.02, 95% confidence interval = 0.66-1.59) or ED visit (odds ratio = 0.88, 95% CI = 0.48-1.59). We used Cox regression to evaluate ASD and nonunion, and logistic regression to evaluate 90-day emergency department (ED) visit, readmission, and complication. The matched sample included 154 PEEK and 308 Ti fusions. Fusions using Ti rods were 2:1 propensity score matched to PEEK rods on the following factors: patient age, body mass index, smoking, American Society of Anesthesiologists classification, diagnosis, interbody use, bone morphogenic protein use, number of levels fused, fusion levels, and operative year. Patients aged ≥18 undergoing first posterior lumbar fusion for a degenerative diagnosis from 2009 to 2018 using either a PEEK or a Ti rod were identified. Consequently, we conducted a matched cohort study using data from Kaiser Permanente's spine registry to compare the 2 rod systems and risk for outcomes. However, few studies have follow-up beyond 2 years.
Polyetheretherketone (PEEK) rods were clinically introduced in the mid-2000s as an alternative to titanium (Ti) rods for posterior instrumented lumbar spine fusion, theorized to reduce the risk of adjacent segment disease (ASD).
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