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REVIEW ARTICLE

Progress, challenges, and clinical prospects of hydrogel-based bioinks in spinal fusion applications

Yuanchen Zhu1 ,  Robert D. Johnston1 ,  Kulwinder Kaur2 ,  Ciara M. Murphy1,3,4*
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1 Tissue Engineering Research Group, Department of Anatomy & Regenerative Medicine, RCSI University of Medical and Health Sciences, Dublin , Ireland
2 School of Pharmacy & Biomolecular Sciences, RCSI University of Medical and Health Sciences, Dublin , Ireland
3 Trinity Centre for Biomedical Engineering (TCBE), Trinity College Dublin (TCD), Dublin , Ireland
4 Advanced Materials and Bioengineering Research Centre (AMBER), RCSI and TCD, Dublin , Ireland
IJB, 026120105 https://doi.org/10.36922/IJB026120105
Received: 20 March 2026 | Revised: 7 May 2026 | Accepted: 11 May 2026 | Published online: 12 May 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Traditional spinal fusion cages and autologous bone grafts face well-recognized limitations, creating a growing clinical need for next-generation fusion technologies. Research has accelerated the development of bioactive materials, with hydrogels emerging as a particularly versatile class for bone repair. These materials can provide structural support while facilitating tissue regeneration through the incorporation of therapeutics that promote integration with native bone. The convergence of hydrogel design and bioprinting technologies may enable customizable, biologically active fusion constructs that function with the body’s repair mechanisms, allowing for more personalized and optimal treatment outcomes. This review summarizes current research on bioprinted hydrogel systems, focusing on materials selection, mechanical strength, degradability, bioink printability, and nanomaterial incorporation. It also discusses pre-clinical and computational approaches for assessing how scaffold design, material selection, printing parameters, printing strategies, and material flow affect mechanical behavior, material properties, and cell viability. Overall, the review highlights potential research avenues for developing new therapeutic platforms for spinal fusion applications.

Graphical abstract
Keywords
Spinal fusion
Hydrogels
Bioprinting
Therapeutic applications
Mechanics
In vivo assessment
In silico modeling
Funding
Dr Murphy acknowledges funding from the European Union (ERC, RESTORE, 101125820). Views and opinions expressed are, however, those of the author(s) only and do not necessarily reflect those of the European Union or the European Research Council. Neither the European Union nor the granting authority can be held responsible for them. Dr Murphy and Mr Zhu acknowledge funding from the RCSI Strategic Academic Recruitment (StAR) program.
Conflict of interest
The authors declare they have no competing interests.
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International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing
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