Implant Surface Technologies to Promote Spinal Fusion: A Narrative Review

Article Figures & Data

Table

Advantages and disadvantages of implant surface technologies.

Surface Material	Advantages	Disadvantages
Interbody
Titanium/HA-coated titanium/other surface-treated titanium	Strong biomechanical profile, biocompatible, and well studied	High stiffness increases risk of subsidence
Titanium-PEEK	Good fusion profile and radiolucent on imaging	Poor wear resistance, limited clinical data, and risk of delamination
PEEK	Radiolucent and biomechanical profile similar to native bone	Poor wear resistance, inferior fusion rate relative to auto/allograft, and fibrous scar formation
Silicon nitride	Low infection risk and good osseointegration	High cost, limited clinical data, and brittle
Tantalum	High fusion rate/biocompatibility	Radiopaque, difficult machining, and high cost
Pedicle Screws
Roughened titanium	Improved osseointegration and pullout threshold	Lacking human clinical data
HA-coated screws	Improved osseointegration and pullout threshold	Lacking long-term randomized controlled trials
Carbon-fiber-PEEK	Radiolucent with reduced artifact in postoperative imaging	High cost and low availability; similar risk of loosening compared with traditional screws
Gold nanoparticle	Improved osseointegration	Lacking human clinical data
Silver nanoparticle	Decreased risk of infection	Lacking human clinical data