3D Printed Implant Facilitates Endoscopic Spinal Surgery

A novel spinal fusion implant printed with electron beam melt (EBM) technology aids minimally invasive endoscopic spinal surgery.

The Endoscopic Lumbar Interbody Fusion (EndoLIF) On-Cage implant is made of Ti6Al4V titanium alloy, and is characterized by a porous surface with diamond cell structure, providing an optimal base for cell proliferation and bone growth. The implant is available in 30 and 35 mm lengths, and with one mm increases in the height from 8 to 14 mm. It can also be filled with autologous bone or bone substitute via two large openings, supporting the creation of a straight fusion column. Implant design allows verification of bone fusion progress by X-ray or computerized tomography (CT) imaging.


The system is intended to be used in conjunction with posterior fixation, such as via a percutaneous pedicle screw-rod system. Cage implantation can be performed with a posterior or posterolateral approach, using an open or endoscopic-assisted method via an inter-muscular approach into the intervertebral disc, similar to a mini transforaminal lumbar interbody fusion (TLIF). Since access is dura and nerve-gentle, it preserves the dorsal bony structures, thus avoiding potential scar tissue due to stepwise tissue dilation. The EndoLIF On-Cage implant is a product of joimax (Karlsruhe, Germany), and has been approved by the US Food and Drug Administration (FDA).

“With the EndoLIF program, joimax offers a complete endoscopic-assisted solution for spinal stabilization and fusion. In the future, we will be able to treat patients with even more gentle techniques,” said Wolfgang Ries, CEO and founder of joimax. “Our next development will be an EndoLIF Cage on the basis of our iLESSYS Delta system for posterior lumbar inter-body fusion (PLIF).”

Ti6Al4V is highly osseointegrative and has improved mechanical properties in comparison with pure titanium. Incorporation of foreign atoms, such as iron and oxygen are carefully observed, thereby increasing ductility (plastic deformation) and break strength is increased. Osseointegration is also enhanced by the porous structure produced when using the EBM technique in monolithic form.

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