AccScience Publishing / IJB / Online First / DOI: 10.36922/IJB026140127
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RESEARCH ARTICLE

Ta/PEEK cages with enhanced hydrophilicity and cell adhesion improve intervertebral fusion in a rabbit model of extreme lateral intervertebral fusion

Shaorong Li1 ,  Han Wu1 ,  Hongwei Gao1 ,  Jianshi Song1 ,  Xiuqi Shan1 ,  Jiaqi Li1 ,  Lei Ma1 ,  Wei Zhang1*
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1 Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
IJB, 026140127 https://doi.org/10.36922/IJB026140127
Received: 1 April 2026 | Revised: 7 June 2026 | Accepted: 15 June 2026 | Published online: 15 June 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

Conventional polyether ether ketone (PEEK) and titanium (Ti) cages for intervertebral fusion exhibit inherent limitations in bioactivity and elastic modulus, necessitating surface modification to enhance their performance. This study developed bioactive cages by fabricating hydroxyapatite-coated Ti (HA/Ti) and tantalum-coated PEEK (Ta/PEEK) cages and evaluated their physicochemical properties, cellular responses, and intervertebral fusion performance in a rabbit extreme lateral intervertebral fusion model. Both coatings improved surface wettability and maintained the intrinsic mechanical properties of the substrates. Ta/PEEK showed superior coating adhesion and enhanced expression of bone marrow-derived mesenchymal stem cell adhesion-related markers, whereas HA/Ti more strongly promoted osteogenic differentiation and matrix mineralization in vitro. In vivo, both coated cages significantly improved intervertebral fusion compared with uncoated Ti and PEEK cages. HA/Ti induced greater new bone formation, while Ta/PEEK enhanced cell adhesion and angiogenesis, as indicated by increased cadherin-1, integrin α2, cluster of differentiation 31, and hypoxia-inducible factor 1α expression. These findings suggest that Ta/PEEK cages provide a mechanically compatible and biologically active strategy for improving intervertebral fusion and represent a promising platform for next-generation printed spinal implants.

Graphical abstract
Keywords
Cage
Hydroxyapatite
Intervertebral fusion
Polyether ether ketone
Tantalum
Extreme lateral intervertebral fusion
Funding
This work was supported by the 2024 Hebei Provincial Traditional Chinese Medicine Scientific Research Project Plan [grant number 2024045]; 2025 Hebei Provincial Medical Applicable Technology Tracking Project [grant number GZ20250025]; and 2026 Hebei Provincial Higher Education Scientific Research Project [grant number CXZX2026045].
Conflict of interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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International Journal of Bioprinting, Electronic ISSN: 2424-8002 Print ISSN: 2424-7723, Published by AccScience Publishing
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