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Introduction <p>Carbon fiber–reinforced polyetheretherketone (CFR-PEEK) spinal implants lessen MRI artifacts compared with titanium, potentially improving surveillance and radiotherapy planning; pediatric experience remains limited. We sought to demonstrate feasibility and imaging/radiotherapy workflow advantages in children with spinal tumors.</p> Case descriptions <p>An 11-year-old boy with retroclival chordoma underwent occipitocervical fusion (occiput–C5) using CFR-PEEK lateral mass screws with conventional occipital hardware; postoperative MRI sharply delineated the operative bed and enabled proton planning; he is disease-free at 6&#xa0;months. A 15-year-old boy with recurrent L2–L3 Ewing sarcoma underwent laminectomy with facetectomy, gross-total resection, and L2–L3 fusion using CFR-PEEK pedicle screws; postoperative imaging showed minimal artifact and facilitated proton planning; he is disease-free at 11&#xa0;months.</p> Discussion <p>Across both cases, radiolucency and markedly reduced artifact improved visualization of the tumor bed and thecal sac, supporting accurate target definition for proton therapy without compromising construct stability; pediatric constraints (e.g., lack of CFR-PEEK occipital components) were manageable with hybrid hardware.</p> Conclusion <p>CFR-PEEK appears to be a practical and promising option for pediatric spinal oncology when long-term MRI surveillance and adjuvant radiotherapy are anticipated. Our experience, alongside a focused literature review, supports selective use and motivates prospective pediatric studies to confirm imaging, radiotherapy, and durability benefits.</p>

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Carbon fiber-reinforced polyetheretherketone spinal instrumentation in pediatric spinal tumors: report of two cases and review of the literature

  • 期刊论文

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  • 发表日期：

    2026年2月10日

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  • Tomoko Tanaka,
  • Eliezer Villanueva-Castro,
  • Hector Soriano-Baron

摘要

Introduction

Carbon fiber–reinforced polyetheretherketone (CFR-PEEK) spinal implants lessen MRI artifacts compared with titanium, potentially improving surveillance and radiotherapy planning; pediatric experience remains limited. We sought to demonstrate feasibility and imaging/radiotherapy workflow advantages in children with spinal tumors.

Case descriptions

An 11-year-old boy with retroclival chordoma underwent occipitocervical fusion (occiput–C5) using CFR-PEEK lateral mass screws with conventional occipital hardware; postoperative MRI sharply delineated the operative bed and enabled proton planning; he is disease-free at 6 months. A 15-year-old boy with recurrent L2–L3 Ewing sarcoma underwent laminectomy with facetectomy, gross-total resection, and L2–L3 fusion using CFR-PEEK pedicle screws; postoperative imaging showed minimal artifact and facilitated proton planning; he is disease-free at 11 months.

Discussion

Across both cases, radiolucency and markedly reduced artifact improved visualization of the tumor bed and thecal sac, supporting accurate target definition for proton therapy without compromising construct stability; pediatric constraints (e.g., lack of CFR-PEEK occipital components) were manageable with hybrid hardware.

Conclusion

CFR-PEEK appears to be a practical and promising option for pediatric spinal oncology when long-term MRI surveillance and adjuvant radiotherapy are anticipated. Our experience, alongside a focused literature review, supports selective use and motivates prospective pediatric studies to confirm imaging, radiotherapy, and durability benefits.