Lightning Podiums: Value and Outcomes in Spinal Surgery - Room 801B

Presented by: A. Kranenburg

Author(s):

A. Kranenburg(1), A. Bruggeman(2), S. Martineck(1), P. Slosar(3)

(1) Southern Oregon Orthopedics, Medford, OR, United States
(2) Texas Spine Care Center, San Antonio, TX, United States
(3) SpineCare Medical Group, Daly City, CA, United States

Abstract

Background: Little data exists to describe factors affecting opioid use after TLIF procedures. Research suggests variable osteogenic properties between roughened titanium and PEEK implants that may be relevant to outcomes.1

Objective: To determine if implant surface material properties can influence outcomes and narcotic requirements in patients after TLIF.

Methods: Consecutive patients (single surgeon) underwent 1-level TLIF procedures and were followed for 6 months. Demographics and biologics were similarly matched in each group. Pain and function were assessed by Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Opiate usage was measured in Milligram Morphine Equivalents Per Day (MME/Day) and percentage of subjects not requiring pain medications.

Results: 127 consecutive patients: 43 PEEK followed by 84 micron-scale roughened surface titanium implants. There was a statistically significant difference at 6 months with 77% of titanium patients not requiring narcotics compared to 56% of PEEK patients. Back pain VAS reached statistical significance at 6 months with superior outcomes in the titanium group (2.6) compared to the PEEK group (3.7). ODI scores trended towards better improvement (NS) at 6 months in the titanium patients. Patients with titanium implants had statistically significant reductions in MME/day at 3 and 6-month data points. At 6 months, the titanium group had a mean of 3.6 MME/Day while the PEEK group had a mean of 17.8 MME/day.

Conclusion: Implant properties can influence clinical outcomes and opiate usage in TLIF cases. Patients fused with micron-scale titanium implants recovered faster and required significantly less opioids than their matched counterparts with PEEK implants. 1 Spine; 40 (6) 399-404; 2015.