Titanium Coating Cervical Cage

Product Overview

The Titanium Coating Cervical Cage is a next-generation interbody device specifically engineered for anterior cervical discectomy and fusion (ACDF) procedures. Manufactured with a PEEK substrate and enhanced by a microporous titanium plasma spray coating, this cage promotes rapid bone ongrowth and provides superior immediate stability at the bone-implant interface. The rough, porous surface increases the friction coefficient, effectively reducing micro-motion and the risk of cage migration or subsidence—common concerns in cervical spine surgery. Available in multiple anatomical footprints, including heights from 4 mm to 8 mm, lengths of 14 mm and 16 mm, and widths of 12 mm and 13 mm, this system offers versatile options for restoring disc height, preserving cervical lordosis, and achieving solid segmental fusion. The large central graft window accommodates generous bone graft packing, maximizing the fusion surface area. Combining the biological advantages of titanium coating with the clinical reliability of the ACDF approach, this cage system delivers superior fusion rates and reduces revision burden in patients with cervical degenerative conditions.

Indications for Use

The Titanium Coating Cervical Cage is indicated for the following clinical scenarios:

• Cervical degenerative disc disease at levels C2–C7 with intractable radiculopathy or myelopathy unresponsive to conservative treatment.

• Cervical disc herniation with symptomatic nerve root or spinal cord compression requiring discectomy and interbody fusion.

• Cervical spinal stenosis where restoration of disc height and foraminal volume achieves indirect neural decompression.

• Post-traumatic cervical instability following fracture or ligamentous injury requiring anterior column reconstruction.

• Cervical pseudoarthrosis repair following failed prior ACDF, where the titanium-coated surface provides enhanced biological stimulation for salvage fusion.

• Adjacent segment disease after previous cervical fusion, where a new-level ACDF is indicated.

• Cervical kyphosis correction where restoration of lordotic alignment (7° built-in angle) is necessary for optimal sagittal balance.

• Tumorous lesions of the cervical vertebral body requiring corpectomy and strut grafting with cage support.

Key Advantages

The Titanium Coating Cervical Cage System offers a range of distinct clinical benefits that set it apart from conventional interbody devices.

Titanium Microporous Coating for Biological Fixation – The plasma-sprayed titanium layer creates a three-dimensional porous architecture that promotes active bone ingrowth, achieving biological fixation that rivals autograft. The rough surface increases the contact area by over 60% compared to smooth PEEK, accelerating osseointegration and substantially reducing the risk of implant loosening over time. This porous structure serves as a scaffold for osteoblast migration, with bone ongrowth typically observed as early as 2–3 weeks postoperatively.

Superior Immediate Stability – The high-friction coefficient of the titanium coating provides immediate grip on the vertebral endplates, effectively reducing micro-motion during the critical early healing phase. This enhanced initial stability minimizes the risk of cage subsidence or migration—two of the most common complications in ACDF procedures—and may allow for stand-alone application in select patients with good bone quality.

Anatomical Lordotic Restoration – The 7° lordotic angle built into Cervical Cage-1 restores segmental cervical lordosis, contributing to improved sagittal alignment and preventing iatrogenic kyphosis, which has been linked to poorer clinical outcomes and accelerated adjacent segment degeneration. For cases where a neutral profile is preferred, Cervical Cage-2 offers a parallel (0°) geometry with a more compact footprint.

Optimized Geometry for the ACDF Approach – Designed specifically for the anterior cervical approach, these cages feature a low-profile footprint that accommodates the narrow cervical disc space while providing robust endplate coverage. The anatomical shape ensures optimal load distribution across the vertebral endplates, reducing stress concentrations that can lead to subsidence.

Large Central Graft Window – The generous opening accommodates abundant bone graft—whether autologous local bone, allograft, or synthetic bone substitutes—ensuring a large fusion bed for solid biological bridging across the disc space. This design maximizes the contact area between the graft and the host bone, facilitating the creeping substitution process essential for successful fusion.

Comprehensive Sizing Matrix – With heights ranging from 4 mm to 8 mm, lengths of 14 mm and 16 mm, and widths of 12 mm and 13 mm, the system allows precise anatomical matching to the patient's endplate morphology and disc space dimensions. This comprehensive range reduces the need for extensive inventory while ensuring the right fit for every patient.

Proven High Fusion Rates – Clinical evidence demonstrates that titanium-coated interbody cages achieve fusion rates exceeding 95% at 12 months postoperatively, significantly reducing the need for revision surgery compared to non-coated PEEK alternatives. The combination of biological enhancement and mechanical stability creates an optimal environment for predictable fusion outcomes.

MRI Compatibility with Minimal Artifact – Both the titanium coating and PEEK substrate are fully MRI-compatible, producing minimal imaging artifact. This allows for clear postoperative imaging to assess fusion progression and detect any complications without the interference commonly seen with metallic implants.

Technical Specifications & Sizing

Size Range Overview

The Titanium Coating Cervical Cage System offers two distinct cage geometries to accommodate varying cervical anatomical requirements:

Cervical Cage-1 (GB3Z-11/S):

• Height: 4, 5, 6, 7, 8 mm (five height options)

• Length: 16 mm (fixed)

• Width: 13 mm (fixed)

• Lordotic Angle: 7° (anatomical restoration of cervical lordosis)

Cervical Cage-2 (GB3Z-12/S):

• Height: 4.5, 5.5, 6.5, 7.5 mm (four height options)

• Length: 14 mm (fixed)

• Width: 12 mm (fixed)

• Lordotic Angle: Neutral (0° parallel endplates)

Detailed Dimension Table

Cervical Cage-1 (GB3Z-11/S) – 7° Lordotic Angle

Cervical Cage-2 (GB3Z-12/S) – Neutral Angle (0°)

Note: Both cage designs feature the identical titanium microporous coating technology. The "-S" suffix indicates sterile packaging. Cervical Cage-1 with 7° lordosis is recommended for single- or multi-level ACDF where restoration of cervical lordosis is critical. Cervical Cage-2 with neutral angle (parallel geometry) is suitable for cases where the surgeon prefers a straight profile or where anatomical constraints require a shorter footprint. All cages are supplied sterile and single-use with a validated 5-year shelf life.

Recommended Companion Instrument Set

The Titanium Coating Cervical Cage System is supported by a comprehensive anterior cervical instrument set, which includes:

RFQ – Request for Quotation

Q1: What graft materials are recommended for packing the cervical cage, and what is the optimal graft volume?
A: We recommend packing the central window with autologous cancellous bone harvested from the vertebral body or iliac crest, which provides osteoinductive and osteoconductive properties. For cases where autograft quantity is insufficient, we suggest combining it with bone substitutes such as demineralized bone matrix (DBM), biphasic calcium phosphate, or cancellous allograft chips. The graft volume for the cervical cage (16×13 mm footprint) is approximately 0.8–1.0 cc, and for the 14×12 mm footprint, approximately 0.6–0.8 cc. We recommend firmly packing the graft to avoid void spaces, as this maximizes the biological fusion surface and reduces the risk of pseudoarthrosis. Our clinical experience shows that meticulous graft preparation and packing are essential for achieving the >95% fusion rates reported with this system.

Q2: What is the difference between the 7° lordotic cage and the neutral 0° cage, and when should each be used?
A: The 7° lordotic cage (Cervical Cage-1) is designed to restore and preserve the natural cervical lordotic curvature, which is critical for maintaining sagittal balance and preventing adjacent segment degeneration. This is our recommended choice for most ACDF procedures, particularly at mid-cervical levels (C4–C6) where lordosis is most pronounced. The neutral (0°) cage (Cervical Cage-2) features a shorter 14 mm length and narrower 12 mm width, making it ideal for smaller patients, revision cases with limited disc space, or levels with less lordotic curvature (such as C2–C3 or C7–T1). The selection should be based on preoperative templating and intraoperative assessment of the patient's endplate morphology and disc space dimensions. In many cases, the 7° cage is preferred to avoid iatrogenic kyphosis, which has been linked to poorer clinical outcomes and accelerated adjacent segment degeneration.

Q3: How does the titanium coating compare to hydroxyapatite (HA) coating in terms of osseointegration and clinical outcomes?
A: Both titanium and hydroxyapatite coatings are designed to promote bone ongrowth, but they achieve this through different mechanisms. Titanium coating creates a microporous surface that provides mechanical interlocking and has been shown to upregulate osteogenic gene expression, promoting active bone formation directly on the implant surface. HA coating, while bioactive, can sometimes undergo resorption or delamination over time. Our titanium coating is applied via vacuum plasma spray, which ensures uniform coverage and strong adhesion to the PEEK substrate. Preclinical studies demonstrate that the titanium coating achieves equivalent or superior bone-implant contact compared to HA coatings at 12 weeks, with the added advantage of being unaffected by pH changes in the fusion environment. The rough titanium surface also provides superior immediate friction fixation, reducing micro-motion during the early healing phase—a critical factor for ACDF success.

Q4: What is the recommended surgical technique for cage insertion, and what precautions should be taken to avoid subsidence?
A: The recommended technique begins with thorough disc space preparation—complete removal of the nucleus pulposus and cartilaginous endplate while preserving the subchondral bone plate. We recommend sequential trialing starting with the smallest height to avoid over-distraction of the disc space and annulus. The correct cage height is determined by the one that restores the preoperative disc height (measured on lateral X-ray) without excessive tension on the nerve roots or annulus. Once the appropriate height is confirmed, the final titanium-coated cage is packed with graft and gently impacted into position using the dedicated inserter and impactor. To minimize subsidence risk, ensure that the cage is seated on the apophyseal ring (the dense cortical bone rim of the vertebral endplate) rather than the weaker central cancellous bone. We also recommend placing the cage slightly posteriorly (closer to the posterior vertebral body wall) to maximize endplate contact in the strongest bone region. For patients with osteopenia or osteoporosis, we recommend considering an anterior cervical plate to supplement stability.

Q5: What sterilization methods are recommended for the instrument set, and are the implants supplied sterile?
A: All cervical cages are supplied sterile in individual blister packs, with a 5-year shelf life from the date of manufacture. They are intended for single use only. The instrument set components are non-sterile and must be thoroughly cleaned and steam autoclaved at 134°C for 18 minutes prior to each surgical procedure. The instruments are manufactured from surgical-grade stainless steel with corrosion-resistant finishes and are fully validated for multiple autoclaving cycles. We recommend regular inspection of the inserters and trials for signs of wear, particularly on the engaging surfaces, and annual torque calibration for the screwdrivers if used with plating systems.

Q6: Can this cage be used with an anterior cervical plate, and does the titanium coating interfere with plate fixation?
A: Yes, this cage is fully compatible with all standard anterior cervical plate systems. The titanium coating does not interfere with plate fixation—the cage sits independently within the disc space, and the plate is applied over the vertebral bodies to provide supplemental fixation. In fact, the titanium coating's biological benefits are complemented by plate stabilization, creating a robust construct that is particularly advantageous in multi-level ACDF or in patients with poor bone quality. We offer a full range of cervical plates and screws that have been tested for compatibility with our cage system, ensuring a seamless implant combination. For surgeons who prefer stand-alone cage use, the titanium coating provides sufficient immediate friction stability for single-level procedures in patients with good bone quality and intact posterior elements.