Analysis And Comparison Of Application Of PEEK And Titanium Alloy In Cranioplasty

BackgroundIn cranioplasty,autogenous bone material is still the primary choice.When patients' autogenous skull bone flap can not be reused to repair skull defects,they can choose peek or titanium alloy to customize individual allogeneic implants,which have their own advantages and disadvantages.Although titanium mesh is still favored by many neurosurgeons in cranial reconstruction,new peek materials are more and more popular in cranial reconstruction.Although peek is more and more popular,there are few studies comparing titanium mesh with peek in cranial reconstruction.It is necessary to study and compare these two materials.ObjectvieTo analysis the operation effect of two kinds of repair materials in cranioplasty.Polyetherether ketone(PEEK)or titanium alloy custom-made implants were used to compare the postoperative complication rate,implant failure rate,treatment time and cost,and the application analysis.MethodsDuring the period from January 2009 to December 2019 in the Third Affiliated Hospital of Guangzhou Medical University,we collected and analyzed the electronic medical record data of all patients who underwent cranioplasty with titanium or polyetheretherketone customized implants after craniotomy,incloding the demographic information(gender,age and smoking status),surgical characteristics(time from craniotomy to cranioplasty,operation time,intraoperative blood loss,use of prophylactic antibiotics,size of skull defect area,indication of craniotomy),and basic diseases(hypertension,diabetes,stroke,tumor)of the patients.another,the postoperative complications(readmission,reoperation,customized implant removal,infection,implant exposure,postoperative epilepsy,cerebrospinal fluid leakage,intracranial hematoma formation,subcutaneous hematoma formation)and the hospitalization time and cost of neurosurgery were collected.ResultFinally,57 cases were collected,15 patients with skull defect used peek skull material,42 patients used titanium alloy skull material.There were no statistical differences in demographic characteristics,surgical characteristics and basic diseases between the two groups.Because of the statistically significant differences between the two groups,the data of the two groups were matched by 1: 2 propensity score matching,in which 15 patients with PEEK cranioplasty were compared with 24 patients with titanium mesh.There was no significant difference in complications between the two groups(readmission,reoperation,customized implant removal,infection,implant exposure,postoperative epilepsy,cerebrospinal fluid leakage,intracranial hematoma formation,subcutaneous hematoma formation and neurosurgical treatment hospitalization time).The hospitalization cost of the two groups(10000 yuan)was 17.76 ± 6.4(mean ± standard deviation)in peek group and 4.5 ± 1.9 in titanium alloy group,respectively The difference was statistically significant(P < 0.05).ConclusionThere is no significant difference in the incidence of complications between the two materials in this study after cranioplasty.The selection of these two materials should be based on the clinical data of patients,the compliance of patients with follow-up treatment,comfort,aesthetic requirements and cost analysis.More often it's a two-way choice between the doctor and the patient.Due to the huge cost difference between the two materials,titanium mesh material is still the best choice for the cost performance of allogeneic repair materials.PEEK material will have a better application prospect in the future research with the cost reduction.