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Titanium-Coated Polyetheretherketone Cages Versus Uncoated Polyetheretherketone Cages for Lumbar Spinal Fusion: A Systematic Review and Meta-Analysis
Journal article   Open access   Peer reviewed

Titanium-Coated Polyetheretherketone Cages Versus Uncoated Polyetheretherketone Cages for Lumbar Spinal Fusion: A Systematic Review and Meta-Analysis

Gonzalo Mariscal, Praveer S Vyas, Boyle C Cheng, Jacobus J Arts, Thomay-Claire A Hoelen, Chen Xu and Christopher D Chaput
Global spine journal, 21925682251336716
03 Jun 2025
DOI: https://doi.org/10.1177/21925682251336716
PMID: 40459546
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://pmc.ncbi.nlm.nih.gov/articles/PMC12133797/View
Accepted (AM)Open Access (Publisher-Specific),  Open
url
https://doi.org/10.1177/21925682251336716View
Published, Version of Record (VoR) Open

Abstract

meta-analysis polyetheretherketone titanium PEEK spinal fusion coated
Study Design Systematic review and meta-analysis. Objective A systematic review and meta-analysis of comparative studies was performed to compare the fusion rates, functional outcomes, and complications between Titanium-Coated Polyetheretherketone (TiPEEK) and polyetheretherketone (PEEK) cages. Methods Four databases were systematically searched according to PRISMA. Adult patients who underwent one- or two-level lumbar fusion with TiPEEK or PEEK cages were included in the study. Studies that reported radiographic fusion and functional or complication outcomes were also included. Study quality was assessed using the Cochrane Risk of Bias tool and MINORS criteria. The meta-analysis was performed using Review Manager 5.4. Heterogeneity was assessed using I, and random effects were used to analyze the heterogeneity.Results8 studies (n = 670) were analyzed. TiPEEK showed a significantly higher overall fusion rate (OR 1.83, 95% CI: 1.18-2.83). TiPEEK cages presented significantly higher fusion rates at 6 months (OR 2.52, 95% CI: 1.11 to 5.72), but there were no significant differences at 12 months (OR 1.33, 95% CI: 0.65 to 2.73). No differences were observed in the global ODI (SMD -0.04, 95% CI: -0.15-0.06). There were no significant differences regarding overall subsidence (OR 0.72, 95% CI: 0.48 to 1.07), screw complications (OR 1.25, 95% CI: 0.30-5.27) or reoperations (OR 0.61, 95% CI: 0.11-3.37). Conclusions The results from this study suggest that TiPEEK cages may demonstrate earlier fusion as compared to PEEK cages, particularly at 6 months. However, the functional outcomes and safety profiles were comparable.

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Clinical Neurology
Orthopedics
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