PEEK vs. titanium-coated PEEK implants for spinal fusion: 5 key findings

Surface Technology

A new study published in The Spine Journal compares PEEK implants and PEEK implants with plasma-sprayed titanium coating.


The three implants used in the study had a smooth PEEK, plasma-sprayed titanium-coated PEEK or porous PEEK design. The devices were impacted between two polyurethane blocks in an effort to mimic the implantation in vertebral bodies. The researchers examined the porous PEEK device durability with micro-CT pre- and post-impaction while the titanium-coating coverage was assessed with scanning electron microscopy and energy dispersive X-ray spectroscopy.


Study authors found:


1. Both the PEEK and smooth PEEK devices had minimal surface damage, compared to the titanium-coated devices, which had "substantial visible coating loss."


2. After impaction, the porous PEEK structure maintained a high porosity, which could foster bone growth. The implant also reported minimal changes to the pore size and depth as a result of the impaction.


3. Study authors observed substantial titanium coating loss among the titanium-coated device as a result of impaction, and there was a decrease in surface roughness.


4. The smooth PEEK implants reportedly showed decreased surface roughness after SEM, but minimal signs of damage.


5. Surface modification to interbody fusion devices may promote osseointegration but they could suffer damage during impaction, the study authors concluded.


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