JBJS - 2026-05-21 - Journal Article
Interbody Cages: Surface Technologies in Spinal Implants.
Nassar JE, Ammar LA, Toavs TL, Kim J, Knebel A, Daher M, Shaffrey CI, Daniels AH
Topics
Key Takeaway
No single interbody cage material or surface technology has demonstrated consistent clinical superiority across titanium, PEEK, silicon nitride, or porous tantalum constructs.
Summary Depth
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Summary
This review examines surface technologies of interbody cages, comparing titanium and PEEK as primary materials alongside emerging options including silicon nitride and porous tantalum. Surface modifications—roughening, porosity, and hydroxyapatite coatings—enhance osseointegration and early fusion outcomes. Despite these biological advantages, no material or surface technology demonstrates consistent clinical superiority, precluding definitive evidence-based implant selection.
Key Limitation
The absence of a systematic search strategy, pooled outcome data, or fracture/fusion rate statistics renders this a narrative synthesis incapable of generating practice-changing recommendations.
Original Abstract
➢ Implant surface characteristics play a critical role in promoting osseointegration and long-term spinal fusion success. ➢ Titanium and polyetheretherketone (PEEK) are the most commonly utilized materials in interbody cages, each with distinct advantages and limitations. ➢ Surface modifications such as roughening, porosity, and hydroxyapatite coatings enhance osseointegration and early fusion outcomes. ➢ Emerging materials, including silicon nitride and porous tantalum, demonstrate favorable biological and mechanical properties but require further clinical validation. ➢ No single implant material or surface technology has shown consistent clinical superiority, highlighting the need for ongoing research and evidence-based selection.