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Open AccessFeature PaperArticle

First Results of a New Vacuum Plasma Sprayed (VPS) Titanium-Coated Carbon/PEEK Composite Cage for Lumbar Interbody Fusion

Department of Orthopedic Surgery and Traumatology, Spine Unit, Inselspital, Bern University Hospital, Bern 3010, Switzerland
Spine Surgery Unit, El-Hadra University Hospital, Alexandria University, Alexandria 21561, Egypt
Author to whom correspondence should be addressed.
J. Funct. Biomater. 2018, 9(1), 23;
Received: 21 January 2018 / Revised: 2 March 2018 / Accepted: 8 March 2018 / Published: 14 March 2018
(This article belongs to the Special Issue Biomaterials for Spinal Applications)
The aim of this study was to assess the performance of a new vacuum plasma sprayed (VPS) titanium-coated carbon/polyetheretherketone (PEEK) cage under first use clinical conditions. Forty-two patients who underwent a one or two segment transforaminal lumbar interbody fusion (TLIF) procedure with a new Ca/PEEK composite cage between 2012 and 2016 were retrospectively identified by an electronic patient chart review. Fusion rates (using X-ray), patient’s satisfaction, and complications were followed up for two years. A total of 90.4% of the patients were pain-free and satisfied after a follow up (FU) period of 29.1 ± 9 (range 24–39) months. A mean increase of 3° in segmental lordosis in the early period (p = 0.002) returned to preoperative levels at final follow-ups. According to the Bridwell classification, the mean 24-month G1 fusion rate was calculated as 93.6% and the G2 as 6.4%. No radiolucency around the cage (G3) or clear pseudarthrosis could be seen (G4). In conclusion, biological properties of the inert, hydrophobic surface, which is the main disadvantage of PEEK, can be improved with VPS titanium coating, so that the carbon/PEEK composite cage, which has great advantages in respect of biomechanical properties, can be used safely in TLIF surgery. High fusion rates, good clinical outcome, and low implant-related complication rates without the need to use rhBMP or additional iliac bone graft can be achieved. View Full-Text
Keywords: spine; cage; titanium-coated carbon; PEEK; composite; lumbar fusion spine; cage; titanium-coated carbon; PEEK; composite; lumbar fusion
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Hoppe, S.; Albers, C.E.; Elfiky, T.; Deml, M.C.; Milavec, H.; Bigdon, S.F.; Benneker, L.M. First Results of a New Vacuum Plasma Sprayed (VPS) Titanium-Coated Carbon/PEEK Composite Cage for Lumbar Interbody Fusion. J. Funct. Biomater. 2018, 9, 23.

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