ArticleOrthopedic reviews2026
Osteointegration and Fusion After TLIF: Trabecular Titanium Cage with SVF-Hydrogel Compared with PEEK Cage.
Article in Orthopedic reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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6 authors.
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Abstract
Background: Degenerative lumbar spinal stenosis is a leading cause of disability, and lumbar interbody fusion (LIF) is a common surgical option. However, pseudarthrosis and suboptimal fusion remain important limitations. Porous titanium cages with biologically active hydrogels may enhance osteointegration compared with PEEK implants. Methods: This single-centre prospective randomized trial included 50 patients with lumbar stenosis undergoing single-level TLIF. Patients were allocated 1:1 to Group I (trabecular Ti-6Al-4V cage with autologous bone and stromal-vascular fraction-based heparin-conjugated fibrin hydrogel) or Group II (PEEK cage with autologous bone only). Follow-up was 12 months. Primary endpoints were CT-based fusion at 12 months (Tan classification) and bone density within the cage region (Hounsfield units, HU). Secondary outcomes included pain (VAS), disability (ODI), implant subsidence/migration, operative parameters, and complications. Results: Baseline demographic and clinical characteristics and intraoperative blood loss were comparable between groups. Mean HU values were significantly higher in Group I at 3-4, 6 and 12 months (428.0±68.6 vs 388.8±46.6, p=0.0228; 527.5±81.8 vs 466.4±52.7, p=0.0031; 594.8±78.7 vs 521.0±75.0, p=0.0014). Complete fusion (Tan grade 1) at 12 months was achieved in 68% of Group I versus 32% of Group II patients (p=0.0227). Group I also showed greater VAS and ODI improvement at all postoperative time points. No intraoperative complications or hydrogel-related adverse events were observed. Conclusions: A trabecular titanium cage combined with autologous bone and SVF-based hydrogel appears safe and more effective than a PEEK cage with autograft, providing superior radiological fusion and faster recovery at 12 months.
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