{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:23:32Z","timestamp":1792175012317,"version":"4.4.0"},"reference-count":34,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100019266","name":"Korea Medical Device Development Fund","doi-asserted-by":"publisher","award":["KMDF_PR_202009010304"],"award-info":[{"award-number":["KMDF_PR_202009010304"]}],"id":[{"id":"10.13039\/100019266","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","thespinejournalonline.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Spine Journal"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.spinee.2026.06.017","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T15:24:18Z","timestamp":1782401058000},"page":"2082-2093","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["3D-printed porous titanium vs polyetheretherketone cages in lumbar interbody fusion: a prospective, multicenter, randomized controlled trial with bone mineral density stratification"],"prefix":"10.1016","volume":"26","author":[{"given":"Jae-Won","family":"Shin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mun-Su","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Won","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Ho","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joonoh","family":"Seo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hak-Sun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung-Soo","family":"Suk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong Hwan","family":"Moon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si-Young","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7235-4981","authenticated-orcid":false,"given":"Byung Ho","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"6","key":"10.1016\/j.spinee.2026.06.017_bib0001","doi-asserted-by":"crossref","first-page":"637","DOI":"10.3171\/spi.2005.2.6.0637","article-title":"Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 1: introduction and methodology","volume":"2","author":"Resnick","year":"2005","journal-title":"J Neurosurg Spine"},{"issue":"1","key":"10.1016\/j.spinee.2026.06.017_bib0002","first-page":"2","article-title":"Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF\/ATP, LLIF and ALIF","volume":"1","author":"Mobbs","year":"2015","journal-title":"J Spine Surg"},{"issue":"32","key":"10.1016\/j.spinee.2026.06.017_bib0003","doi-asserted-by":"crossref","first-page":"4845","DOI":"10.1016\/j.biomaterials.2007.07.013","article-title":"PEEK biomaterials in trauma, orthopedic, and spinal implants","volume":"28","author":"Kurtz","year":"2007","journal-title":"Biomaterials"},{"issue":"3","key":"10.1016\/j.spinee.2026.06.017_bib0004","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.biomaterials.2005.07.011","article-title":"Polyetheretherketone as a biomaterial for spinal applications","volume":"27","author":"Toth","year":"2006","journal-title":"Biomaterials"},{"issue":"6","key":"10.1016\/j.spinee.2026.06.017_bib0005","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1097\/BRS.0000000000000778","article-title":"Implant materials generate different peri-implant inflammatory factors: poly-ether-ether-ketone promotes fibrosis and microtextured titanium promotes osteogenic factors","volume":"40","author":"Olivares-Navarrete","year":"2015","journal-title":"Spine (Phila Pa 1976)"},{"issue":"1","key":"10.1016\/j.spinee.2026.06.017_bib0006","doi-asserted-by":"crossref","first-page":"124","DOI":"10.31616\/asj.2023.0128","article-title":"A comparison between structural allografts and polyetheretherketone interbody spacers used in anterior cervical discectomy and fusion: a systematic review and meta-analysis","volume":"18","author":"Fong","year":"2024","journal-title":"Asian Spine J"},{"issue":"2","key":"10.1016\/j.spinee.2026.06.017_bib0007","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1111\/os.12098","article-title":"Spine interbody implants: material selection and modification, functionalization and bioactivation of surfaces to improve osseointegration","volume":"6","author":"Rao","year":"2014","journal-title":"Orthop Surg"},{"key":"10.1016\/j.spinee.2026.06.017_bib0008","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1055\/s-0037-1604284","article-title":"Fusion rates of intervertebral polyetheretherketone and titanium cages without bone grafting in posterior interbody lumbar fusion surgery for degenerative lumbar instability","volume":"78","author":"Wrangel","year":"2017","journal-title":"J Neurol Surg Cent Eur Neurosurg"},{"issue":"2","key":"10.1016\/j.spinee.2026.06.017_bib0009","first-page":"451","article-title":"Three-dimensional-printed titanium versus polyetheretherketone cages for lumbar interbody fusion: a systematic review of comparative in vitro","volume":"20","author":"Patel","year":"2023","journal-title":"Anim Hum Stud Neurospine"},{"issue":"5","key":"10.1016\/j.spinee.2026.06.017_bib0010","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1007\/s00586-021-06748-w","article-title":"Titanium (Ti) cages may be superior to polyetheretherketone (PEEK) cages in lumbar interbody fusion: a systematic review and meta-analysis of clinical and radiological outcomes of spinal interbody fusions using Ti versus PEEK cages","volume":"30","author":"Tan","year":"2021","journal-title":"Eur Spine J"},{"key":"10.1016\/j.spinee.2026.06.017_bib0011","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.wneu.2023.12.111","article-title":"Comparison of 3D-printed porous titanium cages versus polyetheretherketone cages in lumbar interbody fusion: a systematic review and meta-analysis","volume":"183","author":"Duan","year":"2024","journal-title":"World Neurosurg"},{"key":"10.1016\/j.spinee.2026.06.017_bib0012","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.wneu.2024.09.122","article-title":"Titanium cages versus polyetheretherketone cages in interbody fusions: a meta-analysis of clinical and radiographic outcomes","volume":"193","author":"Daher","year":"2025","journal-title":"World Neurosurg"},{"issue":"1","key":"10.1016\/j.spinee.2026.06.017_bib0013","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1007\/s10143-025-03453-w","article-title":"Clinical and radiological outcomes of titanium cage versus polyetheretherketone cage in lumbar interbody fusion: a systematic review and meta-analysis","volume":"48","author":"Wang","year":"2025","journal-title":"Neurosurg Rev"},{"key":"10.1016\/j.spinee.2026.06.017_bib0014","doi-asserted-by":"crossref","first-page":"1389533","DOI":"10.3389\/fmed.2024.1389533","article-title":"3D-printed porous titanium versus polyetheretherketone cages in lateral lumbar interbody fusion: a systematic review and meta-analysis of subsidence","volume":"11","author":"Liu","year":"2024","journal-title":"Front Med (Lausanne)"},{"issue":"1","key":"10.1016\/j.spinee.2026.06.017_bib0015","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1177\/21925682251336750","article-title":"Polyetheretherketone vs titanium cages in spinal fusion: spin bias in abstracts of systematic reviews and meta-analyses","volume":"16","author":"Avetisian","year":"2025","journal-title":"Global Spine J"},{"key":"10.1016\/j.spinee.2026.06.017_bib0016","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jocn.2017.06.062","article-title":"Titanium vs. polyetheretherketone (PEEK) interbody fusion: meta-analysis and review of the literature","volume":"44","author":"Seaman","year":"2017","journal-title":"J Clin Neurosci"},{"key":"10.1016\/j.spinee.2026.06.017_bib0017","doi-asserted-by":"crossref","first-page":"E1216","DOI":"10.1097\/BRS.0000000000001605","article-title":"Vertebral endplate cyst as a predictor of nonunion after lumbar interbody fusion: comparison of titanium and polyetheretherketone cages","volume":"41","author":"Tanida","year":"2016","journal-title":"Spine (Phila Pa 1976)"},{"issue":"3","key":"10.1016\/j.spinee.2026.06.017_bib0018","doi-asserted-by":"crossref","first-page":"524","DOI":"10.14245\/ns.2244140.070","article-title":"Comparison between 3-dimensional-printed titanium and polyetheretherketone cages: 1-year outcome after minimally invasive transforaminal interbody fusion","volume":"19","author":"Kim","year":"2022","journal-title":"Neurospine"},{"issue":"15","key":"10.1016\/j.spinee.2026.06.017_bib0019","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1056\/NEJMoa1513721","article-title":"A randomized, controlled trial of fusion surgery for lumbar spinal stenosis","volume":"374","author":"F\u00f6rsth","year":"2016","journal-title":"N Engl J Med"},{"key":"10.1016\/j.spinee.2026.06.017_bib0020","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1007\/s00586-013-2772-y","article-title":"Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up","volume":"22","author":"Chen","year":"2013","journal-title":"Eur Spine J"},{"issue":"3","key":"10.1016\/j.spinee.2026.06.017_bib0021","doi-asserted-by":"crossref","first-page":"444","DOI":"10.31616\/asj.2023.0407","article-title":"Innovative developments in lumbar interbody cage materials and design: a comprehensive narrative review","volume":"18","author":"Chang","year":"2024","journal-title":"Asian Spine J"},{"issue":"4","key":"10.1016\/j.spinee.2026.06.017_bib0022","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.spinee.2007.03.013","article-title":"Fusion assessment of posterior lumbar interbody fusion using radiolucent cages: x-ray films and helical computed tomography scans","volume":"8","author":"Fogel","year":"2008","journal-title":"Spine J"},{"issue":"12","key":"10.1016\/j.spinee.2026.06.017_bib0023","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1097\/00007632-199506020-00014","article-title":"Anterior fresh frozen structural allografts in the thoracic and lumbar spine. Do they work if combined with posterior fusion and instrumentation in adult patients with kyphosis or anterior column defects?","volume":"20","author":"Bridwell","year":"1995","journal-title":"Spine (Phila Pa 1976)"},{"issue":"7889","key":"10.1016\/j.spinee.2026.06.017_bib0024","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/S0140-6736(74)90884-8","article-title":"Measurement of pain","volume":"2","author":"Huskisson","year":"1974","journal-title":"Lancet"},{"issue":"22","key":"10.1016\/j.spinee.2026.06.017_bib0025","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.1097\/00007632-200011150-00017","article-title":"The Oswestry Disability Index","volume":"25","author":"Fairbank","year":"2000","journal-title":"Spine (Phila Pa 1976)"},{"issue":"5","key":"10.1016\/j.spinee.2026.06.017_bib0026","doi-asserted-by":"crossref","first-page":"598","DOI":"10.3171\/2010.12.SPINE10472","article-title":"Utility of minimum clinically important difference in assessing pain, disability, and health state after transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis","volume":"14","author":"Parker","year":"2011","journal-title":"J Neurosurg Spine"},{"issue":"11","key":"10.1016\/j.spinee.2026.06.017_bib0027","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1016\/j.spinee.2017.06.018","article-title":"Transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) in lumbar spondylolisthesis: a systematic review and meta-analysis","volume":"17","author":"De Kunder","year":"2017","journal-title":"Spine J"},{"issue":"1","key":"10.1016\/j.spinee.2026.06.017_bib0028","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1177\/21925682251347528","article-title":"Lumbar fusion with micro- & nano-textured, 3D printed porous titanium versus PEEK interbody cages in TLIF: a single-blinded, randomized controlled trial","volume":"16","author":"Weinberg","year":"2026","journal-title":"Global Spine J"},{"issue":"5","key":"10.1016\/j.spinee.2026.06.017_bib0029","doi-asserted-by":"crossref","first-page":"709","DOI":"10.3171\/2023.6.SPINE23382","article-title":"Promotion of higher rates of early fusion using activated titanium versus polyetheretherketone cages in adults undergoing 1- and 2-level transforaminal lumbar interbody fusion procedures: a randomized controlled trial","volume":"39","author":"Toop","year":"2023","journal-title":"J Neurosurg Spine"},{"issue":"7","key":"10.1016\/j.spinee.2026.06.017_bib0030","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1016\/j.spinee.2018.02.018","article-title":"Bony ingrowth potential of 3D-printed porous titanium alloy: a direct comparison of interbody cage materials in an in vivo ovine lumbar fusion model","volume":"18","author":"McGilvray","year":"2018","journal-title":"Spine J"},{"issue":"10","key":"10.1016\/j.spinee.2026.06.017_bib0031","doi-asserted-by":"crossref","first-page":"2150","DOI":"10.1007\/s00586-014-3466-9","article-title":"Comparison of fusion rates following transforaminal lumbar interbody fusion using polyetheretherketone cages or titanium cages with transpedicular instrumentation","volume":"23","author":"Nemoto","year":"2014","journal-title":"Eur Spine J"},{"issue":"2","key":"10.1016\/j.spinee.2026.06.017_bib0032","doi-asserted-by":"crossref","first-page":"265","DOI":"10.14444\/8422","article-title":"Lateral lumbar interbody fusion using expandable vs static titanium interbody cages: a prospective cohort study of clinical and radiographic outcomes","volume":"17","author":"Huo","year":"2023","journal-title":"Int J Spine Surg"},{"issue":"3","key":"10.1016\/j.spinee.2026.06.017_bib0033","doi-asserted-by":"crossref","first-page":"973","DOI":"10.14245\/ns.2448244.122","article-title":"Effect of cage material and size on fusion rate and subsidence following biportal endoscopic transforaminal lumbar interbody fusion","volume":"21","author":"You","year":"2024","journal-title":"Neurospine"},{"issue":"11","key":"10.1016\/j.spinee.2026.06.017_bib0034","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1016\/j.spinee.2016.07.531","article-title":"Comparison of fusion rate and clinical results between CaO-SiO2-P2O5-B2O3 bioactive glass ceramics spacer with titanium cages in posterior lumbar interbody fusion","volume":"16","author":"Lee","year":"2016","journal-title":"Spine J"}],"container-title":["The Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1529943026001932?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1529943026001932?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:32:17Z","timestamp":1792063937000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1529943026001932"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":34,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["S1529943026001932"],"URL":"https:\/\/doi.org\/10.1016\/j.spinee.2026.06.017","relation":{},"ISSN":["1529-9430"],"issn-type":[{"value":"1529-9430","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"3D-printed porous titanium vs polyetheretherketone cages in lumbar interbody fusion: a prospective, multicenter, randomized controlled trial with bone mineral density stratification","name":"articletitle","label":"Article Title"},{"value":"The Spine Journal","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.spinee.2026.06.017","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}