Interbody Cages: Surface Technologies in Spinal Implants.

Nassar, Joseph E; Ammar, Lama A; Toavs, Trevor L; Kim, Jinseong; Knebel, Ashley; Daher, Mohammad; Shaffrey, Christopher I; Daniels, Alan H · J Bone Joint Surg Am · 2026

basic_science · Level V

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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.