{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:48:26Z","timestamp":1792090106155,"version":"4.4.0"},"reference-count":47,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,4,3]],"date-time":"2022-04-03T00:00:00Z","timestamp":1648944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Regional Development Fund under Priority Axis 1 Research and innovation, Measure 1.2 Targeted research","award":["WND-RPPD.01.02.01-20-0081\/17"],"award-info":[{"award-number":["WND-RPPD.01.02.01-20-0081\/17"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Intervertebral cages made of Ti6Al4V alloy show excellent osteoconductivity, but also higher stiffness, compared to commonly used polyether-ether-ketone (PEEK) materials, that may lead to a stress-shielding effect and implant subsidence. In this study, a metallic intervertebral fusion cage, with improved mechanical behavior, was manufactured by the introduction of a three-dimensional (3D) mesh structure to Ti6Al4V material, using an additive manufacturing method. Then, the mechanical and biological properties of the following were compared: (1) PEEK, with a solid structure, (2) 3D-printed Ti6Al4V, with a solid structure, and (3) 3D-printed Ti6Al4V, with a mesh structure. A load-induced subsidence test demonstrated that the 3D-printed mesh Ti6Al4V cage had significantly lower tendency (by 15%) to subside compared to the PEEK implant. Biological assessment of the samples proved that all tested materials were biocompatible. However, both titanium samples (solid and mesh) were characterized by significantly higher bioactivity, osteoconductivity, and mineralization ability, compared to PEEK. Moreover, osteoblasts revealed stronger adhesion to the surface of the Ti6Al4V samples compared to PEEK material. Thus, it was clearly shown that the 3D-printed mesh Ti6Al4V cage possesses all the features for optimal spinal implant, since it carries low risk of implant subsidence and provides good osseointegration at the bone-implant interface.<\/jats:p>","DOI":"10.3390\/ijms23073985","type":"journal-article","created":{"date-parts":[[2022,4,3]],"date-time":"2022-04-03T06:04:01Z","timestamp":1648965841000},"page":"3985","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Mesh Ti6Al4V Material Manufactured by Selective Laser Melting (SLM) as a Promising Intervertebral Fusion Cage"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6076-1309","authenticated-orcid":false,"given":"Agata","family":"Przekora","sequence":"first","affiliation":[{"name":"Independent Unit of Tissue Engineering and Regenerative Medicine, Medical University of Lublin, Chodzki 1 Street, 20-093 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5893-7168","authenticated-orcid":false,"given":"Paulina","family":"Kazimierczak","sequence":"additional","affiliation":[{"name":"Independent Unit of Tissue Engineering and Regenerative Medicine, Medical University of Lublin, Chodzki 1 Street, 20-093 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1918-6912","authenticated-orcid":false,"given":"Michal","family":"Wojcik","sequence":"additional","affiliation":[{"name":"Independent Unit of Tissue Engineering and Regenerative Medicine, Medical University of Lublin, Chodzki 1 Street, 20-093 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil","family":"Chodorski","sequence":"additional","affiliation":[{"name":"ChM sp. z o.o., Lewickie 3b Street, 16-061 Juchnowiec Ko\u015bcielny, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4831-9363","authenticated-orcid":false,"given":"Jacek","family":"Kropiwnicki","sequence":"additional","affiliation":[{"name":"ChM sp. z o.o., Lewickie 3b Street, 16-061 Juchnowiec Ko\u015bcielny, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101","DOI":"10.14245\/ns.1938296.148","article-title":"Biomaterials in spinal implants: A review","volume":"17","author":"Warburton","year":"2020","journal-title":"Neurospine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s13191-013-0252-z","article-title":"Osseointegration: An update","volume":"13","author":"Parithimarkalaignan","year":"2013","journal-title":"J. Indian Prosthodont. Soc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"111612","DOI":"10.1016\/j.msec.2020.111612","article-title":"Ex vivo determination of chitosan\/curdlan\/hydroxyapatite biomaterial osseointegration with the use of human trabecular bone explant: New method for biocompatibility testing of bone implants reducing animal tests","volume":"119","author":"Przekora","year":"2021","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_4","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."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jphotobiol.2018.07.016","article-title":"Developments of nano-TiO2 incorporated hydroxyapatite\/PEEK composite strut for cervical reconstruction and interbody fusion after corpectomy with anterior plate fixation","volume":"187","author":"Kong","year":"2018","journal-title":"J. Photochem. Photobiol. B Biol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.biomaterials.2018.09.009","article-title":"Porous PEEK improves the bone-implant interface compared to plasma-sprayed titanium coating on PEEK","volume":"185","author":"Torstrick","year":"2018","journal-title":"Biomaterials"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/j.spinee.2014.12.018","article-title":"Plasma-sprayed titanium coating to polyetheretherketone improves the bone-implant interface","volume":"15","author":"Walsh","year":"2015","journal-title":"Spine J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1002\/jbm.b.32861","article-title":"Coating of carbon fiber-reinforced polyetheretherketone implants with titanium to improve bone apposition","volume":"101","author":"Devine","year":"2013","journal-title":"J. Biomed. Mater. Res.\u2014Part B Appl. Biomater."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"9264","DOI":"10.1016\/j.biomaterials.2013.08.071","article-title":"Cytocompatibility, osseointegration, and bioactivity of three-dimensional porous and nanostructured network on polyetheretherketone","volume":"34","author":"Zhao","year":"2013","journal-title":"Biomaterials"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1002\/jbm.b.33589","article-title":"Cold-spray coating of hydroxyapatite on a three-dimensional polyetheretherketone implant and its biocompatibility evaluated by in vitro and in vivo minipig model","volume":"105","author":"Lee","year":"2017","journal-title":"J. Biomed. Mater. Res.\u2014Part B Appl. Biomater."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.jmbbm.2017.01.043","article-title":"Promising characteristics of gradient porosity Ti-6Al-4V alloy prepared by SLM process","volume":"69","author":"Fojt","year":"2017","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/j.msec.2015.09.046","article-title":"Biomedical potential of chitosan\/HA and chitosan\/\u03b2-1,3-glucan\/HA biomaterials as scaffolds for bone regeneration\u2014A comparative study","volume":"58","author":"Przekora","year":"2016","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"163","DOI":"10.21037\/jss.2017.05.01","article-title":"Elastic modulus in the selection of interbody implants","volume":"3","author":"Heary","year":"2017","journal-title":"J. Spine Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1016\/S1359-6462(01)01132-0","article-title":"Processing of biocompatible porous Ti and Mg","volume":"45","author":"Wen","year":"2001","journal-title":"Scr. Mater."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1023\/A:1014344819558","article-title":"Processing and mechanical properties of autogenous titanium implant materials","volume":"13","author":"Wen","year":"2002","journal-title":"J. Mater. Sci. Mater. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1080\/10255842.2017.1314468","article-title":"Modelling osteoblast adhesion on surface-engineered biomaterials: Optimisation of nanophase grain size","volume":"20","author":"Chen","year":"2017","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"782549","DOI":"10.1155\/2013\/782549","article-title":"Engineering a biocompatible scaffold with either micrometre or nanometre scale surface topography for promoting protein adsorption and cellular response","volume":"2013","author":"Le","year":"2013","journal-title":"Int. J. Biomater."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.jmst.2020.01.006","article-title":"Novel synthesis method combining a foaming agent with freeze-drying to obtain hybrid highly macroporous bone scaffolds","volume":"43","author":"Kazimierczak","year":"2020","journal-title":"J. Mater. Sci. Technol."},{"key":"ref_19","first-page":"11","article-title":"Enhanced osteoblast response to porosity and resolution of additively manufactured Ti-6Al-4V constructs with trabeculae-inspired porosity","volume":"3","author":"Cheng","year":"2016","journal-title":"3D Print. Addit. Manuf."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1002\/jor.22293","article-title":"Selective laser melting-produced porous titanium scaffolds regenerate bone in critical size cortical bone defects","volume":"31","author":"Waarsing","year":"2013","journal-title":"J. Orthop. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1590\/S1806-83242010000400005","article-title":"Evaluation of bone ingrowth into porous titanium implant: Histomorphometric analysis in rabbits","volume":"24","year":"2010","journal-title":"Braz. Oral Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.matdes.2017.10.040","article-title":"Anisotropic Ti-6Al-4V gyroid scaffolds manufactured by electron beam melting (EBM) for bone implant applications","volume":"137","author":"Ataee","year":"2018","journal-title":"Mater. Des."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"433","DOI":"10.21037\/jss.2017.09.01","article-title":"Systematic review of 3D printing in spinal surgery: The current state of play","volume":"3","author":"Wilcox","year":"2017","journal-title":"J. Spine Surg."},{"key":"ref_24","first-page":"56","article-title":"Additive manufacturing technology for porous metal implant applications and triple minimal surface structures: A review","volume":"4","author":"Yuan","year":"2019","journal-title":"Bioact. Mater."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s40684-017-0037-7","article-title":"Lasers in additive manufacturing: A review","volume":"4","author":"Lee","year":"2017","journal-title":"Int. J. Precis. Eng. Manuf.\u2014Green Technol."},{"key":"ref_26","unstructured":"Melkerson, M., Kirkpatrick, J., and Griffith, S. (2002). A comparison of two strength-testing methodologies for interbody structural allografts for spinal fusion. ASTM Special Technical Publication, ASTM International."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Lim, K.M., Park, T.H., Lee, S.J., and Park, S.J. (2019). Design and biomechanical verification of additive manufactured composite spinal cage composed of porous titanium cover and PEEK body. Appl. Sci., 9.","DOI":"10.3390\/app9204258"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"171","DOI":"10.22603\/ssrr.2019-0089","article-title":"Novel titanium cages for minimally invasive lateral lumbar interbody fusion: First assessment of subsidence","volume":"4","author":"Krafft","year":"2020","journal-title":"Spine Surg. Relat. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"051005","DOI":"10.1115\/1.4036312","article-title":"Interbody Spacer Material Properties and Design Conformity for Reducing Subsidence during Lumbar Interbody Fusion","volume":"139","author":"Chatham","year":"2017","journal-title":"J. Biomech. Eng."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Liu, X., Ma, J., Park, P., Huang, X., Xie, N., and Ye, X. (2017). Biomechanical comparison of multilevel lateral interbody fusion with and without supplementary instrumentation: A three-dimensional finite element study. BMC Musculoskelet. Disord., 18.","DOI":"10.1186\/s12891-017-1387-6"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"103982","DOI":"10.1016\/j.jmbbm.2020.103982","article-title":"Porous fusion cage design via integrated global-local topology optimization and biomechanical analysis of performance","volume":"112","author":"Wang","year":"2020","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.cis.2010.12.007","article-title":"Understanding protein adsorption phenomena at solid surfaces","volume":"162","author":"Rabe","year":"2011","journal-title":"Adv. Colloid Interface Sci."},{"key":"ref_33","unstructured":"Laurencin, C., and Nair, L. (2017). Cell response to nanoscale features and its implications in tissue regeneration: An orthopedic perspective. Nanotechnology and Tissue Engineering: The Scaffold, CRC Press."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Zivic, F., Affatato, S., Trajanovic, M., Schnabelrauch, M., Grujovic, N., and Choy, K.L. (2018). Bioactive Biomaterials: Potential for Application in Bone Regenerative Medicine. Biomaterials in Clinical Practice: Advances in Clinical Research and Medical Devices, Springer International Publishing.","DOI":"10.1007\/978-3-319-68025-5"},{"key":"ref_35","first-page":"207","article-title":"Effect of solution condition on hydroxyapatite formation in evaluating bioactivity of B2O3 containing 45S5 bioactive glasses","volume":"4","author":"Lu","year":"2019","journal-title":"Bioact. Mater."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"S22","DOI":"10.1016\/j.injury.2011.06.008","article-title":"Bioresorbability, porosity and mechanical strength of bone substitutes: What is optimal for bone regeneration?","volume":"42","author":"Hannink","year":"2011","journal-title":"Injury"},{"key":"ref_37","first-page":"1425","article-title":"Effect of surface roughness on osteogenesis in vitro and osseointegration in vivo of carbon fiber-reinforced polyetheretherketone\u2013Nanohydroxyapatite composite","volume":"10","author":"Deng","year":"2015","journal-title":"Int. J. Nanomed."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1007\/s005860100282","article-title":"Osteoinduction, osteoconduction and osseointegration","volume":"10","author":"Albrektsson","year":"2001","journal-title":"Eur. Spine J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"17056","DOI":"10.1038\/boneres.2017.56","article-title":"Calcium phosphate cements for bone engineering and their biological properties","volume":"5","author":"Xu","year":"2017","journal-title":"Bone Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3758","DOI":"10.1038\/ncomms4758","article-title":"Regulation of focal adhesion formation by a vinculin-Arp2\/3 hybrid complex","volume":"5","author":"Chorev","year":"2014","journal-title":"Nat. Commun."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.ejcb.2010.06.007","article-title":"Vinculin, an adapter protein in control of cell adhesion signalling","volume":"90","author":"Carisey","year":"2011","journal-title":"Eur. J. Cell Biol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.msec.2019.01.061","article-title":"The summary of the most important cell-biomaterial interactions that need to be considered during in vitro biocompatibility testing of bone scaffolds for tissue engineering applications","volume":"97","author":"Przekora","year":"2019","journal-title":"Mater. Sci. Eng. C"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2291","DOI":"10.1016\/j.yexcr.2010.05.011","article-title":"Morphological and proteomic analysis of early stage of osteoblast differentiation in osteoblastic progenitor cells","volume":"316","author":"Hong","year":"2010","journal-title":"Exp. Cell Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s00441-010-1086-1","article-title":"Osteoblast physiology in normal and pathological conditions","volume":"343","author":"Neve","year":"2011","journal-title":"Cell Tissue Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s00223-001-2088-5","article-title":"Calcified Tissue International Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) Induces the Osteoblastic Differentiation of the Human Osteosarcoma Cell Line","volume":"2","author":"Postiglione","year":"2003","journal-title":"Calcif. Tissue Int."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ijfatigue.2017.10.021","article-title":"Low- and high-cycle fatigue resistance of Ti-6Al-4V ELI additively manufactured via selective laser melting: Mean stress and defect sensitivity","volume":"107","author":"Benedetti","year":"2018","journal-title":"Int. J. Fatigue"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"6615","DOI":"10.2147\/IJN.S217245","article-title":"Novel chitosan\/agarose\/hydroxyapatite nanocomposite scaffold for bone tissue engineering applications: Comprehensive evaluation of biocompatibility and osteoinductivity with the use of osteoblasts and mesenchymal stem cells","volume":"14","author":"Kazimierczak","year":"2019","journal-title":"Int. J. Nanomed."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/7\/3985\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:49:17Z","timestamp":1760136557000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/23\/7\/3985"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,3]]},"references-count":47,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["ijms23073985"],"URL":"https:\/\/doi.org\/10.3390\/ijms23073985","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,3]]}}}