Titanium and PEEK are the major players in the spinal fusion implant material debate. In an interview with Orthopedic Design & Technology, Titan Spine's Vice President of Marketing Andrew Shepherd identifies key trends in implant material selection.
1. In the 1990s, titanium cages fell out of favor for spinal fusion technologies because the design of the threaded cylindrical cages damaged the vertebral endplate during insertion, often leading to subsidence. The implants contained more titanium material relative to today's designs, which caused scatter on CT images and hindered the ability to assess fusion status.
"We now know that the combination of interbody device material and design is essential," Mr. Shepherd told ODT.
2. Surgeons are warming to titanium, since there is much less metal in today's implants than the threaded implants of the past that caused visualization concerns, according to Mr. Shepherd. He claims that the scatter effect on CT and MRI is now virtually non-existent.
3. As surgeons become more comfortable with the notion that the implant is heavily involved in the bone growth process, the more accepted titanium will become in the industry. Surgeons should be informed of interbody device nano-architecture and its ability to drive bone growth.
4. The market is moving toward surface-enhanced titanium as the dominant spinal interbody fusion technology material. The next step will be to apply surface technology expertise to other spine and orthopedic applications, Mr. Shepherd claims.
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