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Basic Science Research & Clinical Outcomes

"Our research shows that even the slightest change in implant surface structure at the nano level has a large impact on the bone formation response that is created.”



Barbara Boyan, Ph.D.

Dean of the School of Engineering at Virginia Commonwealth University



Extensive research demonstrates that Titan Spine’s roughened surface technologies up-regulate a significantly greater amount of osteogenic and angiogenic growth factors that are necessary for bone growth and fusion when compared to smooth titanium and PEEK.  The following in vitro studies are specific to Titan Spine’s proprietary surface technologies and are not applicable to other roughened titanium interbody fusion devices on the market.



Olivares-Navarrete, R., Gittens, R.A., Schneider, J.M., Hyzy, S.L., Haithcock, D.A., Ullrich, P.F., Schwartz, Z., Boyan, B.D.  (2012).  Osteoblasts exhibit a more differentiated phenotype and increased bone morphogenetic production on titanium alloy substrates than poly-ether-ether-ketone.  The Spine Journal, 12, 265-272.



 [ http://www.thespinejournalonline.com/article/S1529-9430%2812%2900091-5/abstract ]



Olivares-Navarrete, R., Hyzy, S.L., Gittens, R.A., Schneider, J.M., Haithcock, D.A., Ullrich, P.F., Slosar, P. J., Schwartz, Z., Boyan, B.D. Rough titanium alloys regulate osteoblast production of angiogenic factors. The Spine Journal 2013, 13, 1563-1570.



[ http://www.thespinejournalonline.com/article/S1529-9430(13)00399-9/abstract ]



Olivares-Navarrete, R., Hyzy S.L., Gittens, R.A., Berg, M.E., Schneider, J.M., Hotchkiss, K., Schwartz, Z., Boyan, B. D. Osteoblast lineage cells can discriminate microscale topographic features on titanium-aluminum-vanadium surfaces. Ann Biomed Eng. 2014 Dec, 42 (12): 2551-61.



[ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4239824 ]



Olivares-Navarrete, R., Hyzy, S.L., Slosar, P.J., Schneider, J.M., Schwartz, Z., and Boyan, B.D. Implant materials generate different peri-implant inflammatory factors: PEEK promotes fibrosis and micro-textured titanium promotes osteogenic factors.  Spine 2015, 40 (6), 399–404.



[ https://www.ncbi.nlm.nih.gov/pubmed/25584952 ]



Gittens, R.A., Olivares-Navarrete, R., Schwartz, Z., Boyan, B.D. Implant osseointegration and the role of microroughness and nanostructures: Lessons for spine implants. Acta Biomaterialia 2014 Aug, 10, 3363-3371.



[ i>http://www.sciencedirect.com/science/article/pii/S1742706114001573 ]



Matteson, J.L., Greenspan, D.C., Tighe, T.B., Gilfoy, N., Stapleton, J.J. Assessing the hierarchical structure of titanium implant surfaces. Journal of Biomedical Materials Research 2015 May, 104, 1083-1090.



[ Technological advancements in spinal fusion implants: A summary of the current scientific and clinical research on titanium engineered surfaces. Spinal Research Foundation 2014, 9, 35- 41.



Valdevit, A., Dawoud, M. Intervertebral implant performance based on dynamic stiffness response. American Journal of Biomedical Engineering 2015, 5, 79-85.



 [ http://article.sapub.org/10.5923.j.ajbe.20150503.01.html ]



Kienle, A., Graf, N., Wilke, H.J. Does impaction of titanium-coated interbody fusion cages into the disc space cause wear debris or delamination? The Spine Journal 2016 Feb, 16, 235-242.



[ https://www.ncbi.nlm.nih.gov/pubmed/26409208 ]



Banik, B.L., Riley, T.R., Platt, C.J., Brown, J.L. Human mesenchymal stem cell morphology and migration on microtextured titanium. Frontiers in Bioengineering and Biotechnology 2016 May, 4.



[ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4862254/ ]



Slosar, P.J. Spine implant surface technology state of the art: Separating fact



from fiction. Spine 2018 Apr, 43 (7S), S10-S11.



[https://journals.lww.com/spinejournal/Fulltext/2018/04011/Spine_Implant_Surface_Technology_State_of_the_Art_.9.aspx ]



Favorable clinical outcomes have been tied to the in vitro research:



Girasole, G., Muro, G., Mintz, A., Chertoff, J. Transforaminal lumbar interbody fusion rates in patients using a novel titanium implant and demineralized cancellous allograft bone sponge. International Journal of Spine Surgery 2013 Dec, 7, 95-100.



[ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288454/ ]



Slosar, P.J., Kaiser, J., Marrero, L., Sacco, D. Interobserver agreement using computed tomography to assess radiographic fusion criteria with a unique titanium interbody device. The American Journal of Orthopedics 2015 Feb, 44 (2), 86 – 89.



[ https://www.ncbi.nlm.nih.gov/pubmed/25658078 ]



White Papers:



Titan Spine Literature Review White Paper



Titan Spine Condensed Literature Review White Paper



Titan Spine Original Surface vs. nanoLOCK® White Paper



Titanium Plasma White Paper