Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2023 May 11;18(1):348.
doi: 10.1186/s13018-023-03817-2.

Polyetheretherketone (PEEK) rods versus titanium rods for posterior lumbar fusion surgery: a systematic review and meta-analysis

Wenhao Li  1   2 , He Zhao  2 , Chuanhong Li  1   2 , Tao Liu  1   2 , Jianbin Guan  1   2 , Yongdong Yang  1   2 , Xing Yu  3
Affiliations
Meta-Analysis

Polyetheretherketone (PEEK) rods versus titanium rods for posterior lumbar fusion surgery: a systematic review and meta-analysis

Wenhao Li et al. J Orthop Surg Res. .

Abstract

Background: Rigid fixation, represented by titanium rods, is a widely used fixation technique for lumbar fusion. However, this technique carries the risk of degeneration of adjacent segments. In recent years, the semi-rigid fixation technique represented by PEEK rods has gradually matured, and its effectiveness has been verified by numerous studies. The aim of this study was to systematically evaluate the effectiveness of these two fixation modalities in posterior lumbar fusion surgery.

Methods: Studies meeting the inclusion criteria were searched in PubMed, Cochrane Library, ScienceDirect, Embase, CNKI, and Wanfang databases. After data extraction and quality assessment of included studies, meta-analysis was performed using STATA 15.1 software. The protocol for this systematic review was registered on INPLASY (2021110049) and is available in full on the inplasy.com ( https://inplasy.com/inplasy-2021-11-0049/ ).

Results: Fifteen relevant studies were finally included, including eight prospective studies and seven retrospective studies. The results of meta-analysis showed that in ODI (P = 0.000), JOA score (P = 0.017), VAS score for lower limb pain (P = 0.027), fusion rate of bone graft at week 12 (P = 0.001), fusion rate of bone graft at last follow-up (P = 0.028), there was a statistical difference between the two groups. The PEEK rod group was superior to the titanium rod group in the above aspects. While in VAS score for LBP (P = 0.396), there was no statistical difference between the two groups.

Conclusion: Both PEEK rods and titanium rods are effective fixation materials in lumbar fusion surgery. PEEK rods may be superior to titanium rods in improving postoperative function and improving bone graft fusion rates. However, given the limitations of this study, whether these conclusions are applicable needs further research.

Keywords: Lumbar fusion surgery; Meta-analysis; PEEK rod; Titanium rod.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests in this section.

Figures

Fig. 1
Fig. 1
Flow diagram of the study selection process
Fig. 2
Fig. 2
Risk of bias summary: +, low risk of bias; −, high risk of bias; ?, bias unclear
Fig. 3
Fig. 3
Forest plot of ODI between PEEK and titanium rod
Fig. 4
Fig. 4
Forest plot of JOA score between PEEK and titanium rod
Fig. 5
Fig. 5
Forest plot of VAS score for LBP between PEEK and titanium rod
Fig. 6
Fig. 6
Forest plot of VAS score for lower limb pain between PEEK and titanium rod
Fig. 7
Fig. 7
Forest plot of the fusion rate of bone graft at week 12 between PEEK and titanium rod
Fig. 8
Fig. 8
Forest plot of the fusion rate of bone graft at last follow-up between PEEK and titanium rod
Fig. 9
Fig. 9
Sensitivity analysis of ODI
Fig. 10
Fig. 10
Sensitivity analysis of JOA score
Fig. 11
Fig. 11
Sensitivity analysis of VAS score for LBP
Fig. 12
Fig. 12
Sensitivity analysis of VAS score for lower limb pain
Fig. 13
Fig. 13
Sensitivity analysis of the fusion rate of bone graft at week 12
Fig. 14
Fig. 14
Sensitivity analysis of the fusion rate of bone graft at last follow-up
Fig. 15
Fig. 15
Publication bias of ODI
Fig. 16
Fig. 16
Publication bias of JOA score
Fig. 17
Fig. 17
Publication bias of VAS score for LBP
Fig. 18
Fig. 18
Publication bias of VAS score for lower limb pain
Fig. 19
Fig. 19
Publication bias of the fusion rate of bone graft at week 12
Fig. 20
Fig. 20
Publication bias of the fusion rate of bone graft at last follow-up
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. De Iure F, Bosco G, Cappuccio M, Paderni S, Amendola L. Posterior lumbar fusion by peek rods in degenerative spine: preliminary report on 30 cases. Eur Spine J. 2012;21(Suppl 1):S50–S54. doi: 10.1007/s00586-012-2219-x. - DOI - PMC - PubMed
    1. Turner JL, Paller DJ, Murrell CB. The mechanical effect of commercially pure titanium and polyetheretherketone rods on spinal implants at the operative and adjacent levels. Spine (Phila Pa 1976) 2010;35(21):E1076–E1082. doi: 10.1097/BRS.0b013e3181df1b85. - DOI - PubMed
    1. Ogrenci A, Koban O, Yaman O, Yilmaz M, Dalbayrak S. Polyetheretherketone rods in lumbar spine degenerative disease: mid-term results in a patient series involving radiological and clinical assessment. Turk Neurosurg. 2019;29(3):392–399. doi: 10.5137/1019-5149.JTN.24320-18.2. - DOI - PubMed
    1. Toth JM, Wang M, Estes BT, Scifert JL, Seim HB, 3rd, Turner AS. Polyetheretherketone as a biomaterial for spinal applications. Biomaterials. 2006;27(3):324–334. doi: 10.1016/j.biomaterials.2005.07.011. - DOI - PubMed
    1. Kurtz SM, Devine JN. PEEK biomaterials in trauma, orthopedic, and spinal implants. Biomaterials. 2007;28(32):4845–4869. doi: 10.1016/j.biomaterials.2007.07.013. - DOI - PMC - PubMed

LinkOut - more resources