White Paper 1

BlackArmor® Carbon/PEEK Improves Patient Outcomes by Enabling Early Recurrence Detection

This white paper concisely highlights the importance of early recurrence detection in spinal metastases and sets the stage for the benefits of BlackArmor® Carbon/PEEK.

Optimizing Long-Term Care for
Patients with Spinal Metastases
in a Changing Landscape

Thanks to recent medical advancements in systemic treatment, patients suffering from spinal metastases have a longer life expectancy than in the past.1Rothrock, R.J., et al., Survival Trends After Surgery for Spinal Metastatic Tumors: 20-Year Cancer Center Experience. Neurosurgery, 2021. 88(2): p. 402-412.

With longer survival, the likelihood of disease recurrence has increased, making it important to safely monitor patients’ response to treatment, manage symptoms, treat complications, and ensure optimal quality of life.

patients_caroline hernandez

A prospective cohort study of 1,421 patients who had surgery for symptomatic spinal metastases found a 32% recurrence rate and a 20%–22% recurrent spinal cord compression caused by loss of local control. The rate of repeat surgery was found to be between 1.4% and 8.4%.2Depreitere, B., et al., Loss of Local Tumor Control After Index Surgery for Spinal Metastases: A Prospective Cohort Study. World Neurosurg, 2018. 117: p. e8-e16.


MR imaging is particularly essential for the evaluation of disease progression and response as well as for the assessment of soft tissue surrounding the area of the implant, such as the spinal cord, nerve roots, and adjacent organs. The presence of metal implants in stabilized patients presents a unique challenge when interpreting postoperative images. The artifacts caused by these implants can complicate the assessment of disease progression.

When recurrence is identified late, it significantly increases the risk of spinal cord compression, leading to more invasive interventions with higher associated risks and increased side effects for the patient.

BlackArmor® Carbon/PEEK provides artifact-free MR imaging, allowing for safe monitoring of the affected area. A study from MD Anderson revealed safe and effective stabilization for patients with both primary and metastatic tumors, emphasizing the ability to detect local recurrence.3Alvarez-Breckenridge, C., et al., Carbon Fiber-Reinforced Polyetheretherketone Spinal Implants for Treatment of Spinal Tumors: Perceived Advantages and Limitations. Neurospine, 2023. 20(1): p. 317-326

Early recurrence detection translates to less invasive treatment options. Addressing local recurrence at an earlier phase allows for alignment of the treatment with patients’ goals of care.

Early Recurrence
Axial spinal MRI with BlackArmor® Carbon/PEEK implants allowing early detection of recurrence in the proximity of the implants

NOTE: Not all icotec implants have been evaluated for safety in the MR environment.
Some have not been tested for heating or unwanted movement in the MR environment.
The safety of these implants in the MR environment is unknown. Performing an MR exam on
a person who has such a medical device may result in injury. Please consult the respective instructions for use regarding information on the safety and compatibility of the individual icotec implants in the MR environment.