Becker's Spine Review

14 Technology & Innovation T itan Spine is a surface technology company focused on titanium interbody fusion im- plants, and is experiencing successful results. Titan Spine received FDA clearance for its next generation nanoLOCK Surface Technology in November 2014, making it the first FDA clearance for a spinal implant to include nanotechnology. This is just the latest in a long line of surface tech- nology the company offers. The nanoLOCK surface increases the amount of nano-scaled textures as compared to its current surface to up-regulate a statistically significant greater amount of osteogenic and angiogenic growth factors critical for bone growth and fu- sion. 1 The surface is formed by a reductive process of the titanium, which eliminates the potential for delamination and particulate debris that can occur with devices with a PEEK-titanium interface. "What we have learned is that there are very specific implant surface topographies, especially at the nano level, that generate the osteogenic and angiogenic responses necessary to drive bone growth required for a robust fusion," says Paul Slosar, MD, Chief Medical Officer for Titan Spine. Dr. Slosar reported on a study conducted by Barbara Boyan, PhD, Dean of the School of Engineering at Virginia Common- wealth University, comparing Titan Spine's titanium implants with PEEK implants and found the tita- nium implants can stimulate stem cells to behave differently by promoting bone formation instead of creating inflammation and fibrosis. "Through this research, we are able to better un- derstand how implant surface properties influ- ence specific inflammatory micro-environment factors," said Dr. Boyan. "We found that the titani- um alloy surface with a complex micron scale and submicron scale roughness promotes a cellular response that favors bone formation. Conversely, PEEK created an inflammation response that will more likely lead to fibrous tissue formation." Kyle Colle, DO, has been practicing spine sur- gery for several years and was once an avid PEEK product user. He tried titanium implants a few years ago, however, and has never looked back. "I utilized PEEK for many years and experi- enced a lot of subsidence and non-unions," says Dr. Colle. "You are depending on your autograft and other kickers, including bone morphogenetic protein, to promote fusion. But you never get a solid fusion onto PEEK no matter what you stuff it with. The whole interface between bone and PEEK never actually fuses." As a result, Dr. Colle looked for other options. He first tried titanium interbody devices a few years ago and found it to be more "bone friendly." "The Titan titanium devices have several benefits for the patient, including very little subsidence, the disc space is open and keeps the vertebral body from collapsing," says Dr. Colle. "Using the tita- nium spacers also reduced the posterior neck pain." He has seen his patients improve with the titanium impacts and anecdotally achieve better outcomes Spinal Implant Material Matters: What Titanium Can Do for You (and Your Patients) By Laura Dyrda The NEW FACE of I N T E R B O D Y F U S I O N DRIVEN TO INNOVATE GUIDED BY SCIENCE w w w . t i t a n s p i n e . c o m THE LEADER IN SURFACE TECHNOLOGY

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