Material Development Revises Interbody Fusion Technology

New spinal devices combine the two materials most commonly used in interbody fusion procedures, titanium (Ti) and polyetheretherketone (PEEK).

The Medtronic pure titanium coating (PTC) platform includes four products; the CapStone PTC spinal system, the Clydesdale PTC spinal system, the Anatomic PEEK PTC cervical fusion system, and the Cornerstone-SR Ti- coated anatomical cervical cage. The application of a thin layer of textured Ti (about tenth of a millimeter thick) to the top and bottom of each PEEK implant increases the coefficient of friction and the surface area of the implant. The Ti layer, however, is thin enough so that it does not change the mechanical properties or radiolucency of the underlying PEEK implant.


The CapStone PTC spinal system and the Clydesdale PTC spinal system are indicated for interbody fusion with autogenous bone graft in patients with degenerative disc disease (DDD) at one or two level interbody fusions in the lower back or lumbar spine. The Cornerstone-SR Ti- coated anatomical cervical cage is indicated for degenerative discopathy and instability, primary surgery for certain progressive degenerative discopathies, or extensive anterior decompression revision surgery for failed disc operation, stenosis, and postoperative instability pseudarthrosis, or failed arthrodesis.

The Anatomic PEEK PTC cervical fusion system is indicated for cervical interbody fusion procedures in skeletally mature patients with cervical disc disease at one level from the C2-C3 disc to the C7-T1 disc. The device is to be used with supplemental fixation and autogenous and/or allogenic bone graft that is comprised of cancellous and/or corticocancellous bone graft. All PTC systems are products of Medtronic (Minneapolis, MN, USA), based on technology developed by the Gary K. Michelson, MD.

“Our PTC platform of interbody spacers is the result of our relentless effort to add value to our products and respond to surgeon needs by offering the advantages of combined materials in a single implant,” said Doug King, president of the spine business and senior vice president at Medtronic. “We will continue to leverage our innovation to produce more advanced and differentiated products for surgeons to use to treat their patients.”

Both Ti and PEEK have a long clinical history in orthopedic and other medical implants. While surgeons have historically preferred interbody spacers made of Ti because of their strength and long clinical history, over the last 10 years PEEK has largely replaced Ti as the material of choice because it has a modulus of elasticity that is similar to human cortical bone, and because it is radiolucent, thus enabling the surgeon to more easily assess the surgical site over time after surgery.

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