The demand for anterior lumbar interbody fusion (ALIF) has increased due to the following market drivers:
- Increasing number of degenerative disc disease and spondylolisthesis is expected to drive the growth of the market
- Increasing prevalence of scoliosis or flat back syndrome acts as a market driver
- Increasing technological advancement is expected to increase growth of the market
- Anterior lumbar interbody fusion usage provides fast recovery; this factor also uplifts the growth of this market
Today, we present 10 Stand-alone Cages manufactured in Titanium that we think that are worth to know since they are differentiated and aligned with the main market trends:
1.-STALIF M FLX | Centinel Spine
STALIF M FLX is a 3D-printed porous titanium lumbar interbody with 2-level clearance!
Features:
- Flexible
- FLX implants include a solid exoskeleton for added strength, along with a proprietary lattice scaffold designed to have a stiffness similar to bone. Reduced device stiffness is known to minimize stress-shielding and enhance the fusion process.
- Lucent
- FLX implants include porous radiolucent sections with optimized density to reduce imaging artifacts—enhancing intra-operative visualization & post-operative fusion assessment compared to solid titanium implants.
- MatriX
- FLX implants include a FUSE-THRU™ osteoconductive trabecular scaffold, bioengineered to allow the potential for bony on-growth and in-growth throughout the implant. This unique porous structure contains micro, macro, and nano structural characteristics designed to promote the fusion healing process by influencing cellular events related to the production of new bone.
- No Profile®; No Supplemental Fixation
- The integrated cage and screw system of STALIF M FLX is cleared for use without supplemental fixation, while the “No Profile” design allows it to nest fully within the confines of the vertebral body—leaving the anatomy unchanged external to the interbody.
- Large Graft Area
- The implant is designed with a large, open, concave graft containment cavity to maximize the volume of bone graft (allograft and/or autograft) material to better promote fusion.
- Multiple Heights & Footprints
- The STALIF M FLX Interbody system consists of varying heights and footprint options to accommodate individual pathology and anatomical conditions.
2.-HEDRON IA™ | Globus Medical
HEDRON IA™ is a 3D Printed Integrated ALIF spacer that features a biomimetic porous scaffolding designed to encourage cellular response and promote bone formation onto and through the implant.
- The Face of Fusion
- An ovine interbody study demonstrated significantly more bone ingrowth at 6 weeks within HEDRON™ implants post-op compared to PEEK and solid titanium implants.*
- In-line Integrated Fixation
- Innovative instruments facilitate simple implantation even with challenging patient anatomy.
- Intraoperative Versatility
- Compatible with anchors and screws, providing multiple options for securing the spacer to the vertebral bodies.
3.-M3 Stand-Alone ALIF | CoreLink
The M3 Stand-Alone ALIF System features a versatile, diverging 3-screw construct that incorporates the biocompatible benefits of Mimetic Metal® technology with simplified instrumentation.
Features:
- 100% open-pore architecture to allow for osteointegration
- Hydrophilic wicking
- 3D printed titanium with 60% porosity
- Dual-zone microdeflection for reduced stress shielding and increased load sharing along the endplates and inside the lattice
- Cages provided sterile
4.-Arco-SA Ti | Neurostructures
Features:
- Trabecular Structure for Multi-Axial New Bone In-Growth
- Porous Titanium Providing Excellent Long-Term Fixation
- Anatomically Shaped to Match Disc Space Anatomy
- Multiple Footprints & Lordotic Angles Accommodate Patient Anatomy
- Three Screw Fixation & A Simple Active Locking Mechanism per Screw
- Zero-Profile Construct – All Components Fit Completely Within the Disc Space
- Hyper-Lordotic Sizes 18 & 20 Degree
- Side Windows for Additional Bone Growth in the Axial Plane
This product is not cleared by the FDA for distribution in the U.S
5.-Tesera SA Stand-Alone ALIF | Kyocera Medical
The Tesera® SA Stand-Alone ALIF Cage is a porous titanium Stand-alone Anterior Cage designed to be part of the fusion, rather than merely a vessel for it.
Using additive manufacturing, we have created an ideal trabecular structure for bone in-growth, providing excellent long-term fixation. Four screws and an innovative locking system provide immediate fixation and confidence.
Features:
- Truly porous
- Using additive manufacturing, the entire cage is “grown” layer upon layer, in much the same fashion as traditional rapid prototyping, but instead of plastic, we use titanium alloy powder. The final product is a solid structure in the middle, transitioning to a porous structure at the surfaces.
- True porous surfaces (1.15mm thickness)
- Solid superstructure below the porous layer
- Made from Titanium (Ti6Al4V) powder
- Melted into a solid form by electron beam laser
- Using additive manufacturing, the entire cage is “grown” layer upon layer, in much the same fashion as traditional rapid prototyping, but instead of plastic, we use titanium alloy powder. The final product is a solid structure in the middle, transitioning to a porous structure at the surfaces.
- Locking Cover Plate
- A quarter turn is all that it takes to lock all four screws. And with tactile and visual confirmations, you can be confident the system is locked before you close the wound.
- Screw Angles
- Our screw angles are set to provide maximum stability while minimizing risk to surrounding tissue and vascular structures.
- Graft Chamber
- Our cage is designed for strength without the need for braces or crossbars through the middle of the cage. This allows for an extra large graft chamber to maximize the potential for a solid, rapid fusion.
6.- ENZA™-A Titanium ALIF | Camber Spine
MINIMAL ACCESS, MAXIMUM FIXATION
Features:
- All titanium, 3D-printed construct with inferior and superior surfaces specifically designed with a controlled, trabecular pattern to create an environment for fusion to occur.
- The deliberately designed surface includes pores averaging 500µm in diameter – the optimal environment for arthrodesis to occur
- Utilizes a unique anchoring system that consists of two, sharpened, anchor plates that translate from within the device in an angular superior and inferior direction to fixate the device securely to the adjacent vertebrae by providing immediate stability
- Inserter instrument consists of a slim profile with few components allowing for a simpler configuration and direct visualization of implantation of ENZA®-A Titanium ALIF
- ENZA®-A Titanium ALIF can be inserted, deployed and locked all through the in-line instrumentation of the inserter thus reducing complexity and surgery time
- Multiple lumens allow for a large volume of autogenous bone graft material to be packed throughout the implant
- Designed in various implant configurations to conform to patient’s anatomy
- ENZA®-A Titanium ALIF is indicated for use at one or two contiguous levels from L2 to S1 with supplemental fixation
7.-Leva® AF Anterior Stand-Alone Spacer | Spine Wave
The Leva® AF Interbody Device features all-titanium construction, modular anterior plates and a selection of bone screws for integrated and stand alone vertebral body fixation. As with all Leva® brand products, the device also offers a large graft chamber that facilitates copious grafting with complete graft-to-endplate contact within the device. The Leva® AF Interbody Device will also be complemented with a first-in-class expandable option, the Leva® AX Interbody Device, which is currently in limited release.
Attributes of Leva® AF Interbody Device:
- All titanium
- Large graft chamber for maximized bone graft capability
- Modular plate and screws
8.-Endoskeleton TAS | Medtronic
Endoskeleton® TAS system is an ALIF device with integrated fixation screws. The Endoskeleton® TAS incorporates the same macro, micro, and nano surface textures as the company’s Endo TA ALIF device, which has been shown to elicit a superior osteogenic response in comparison to other commercially available interbody materials. In addition, the TAS features three integrated grit-blasted screws that allow up to ten degrees of medial/lateral or anterior/posterior angulation. The manufacturer is offering a warranty and through the warranty, the manufacturer provides a one-time free replacement of any eligible Endoskeleton spinal interbody fusion device if revision surgery is required within the five year warranty period, as outlined within the terms of the agreement.Previously available from Titan Spine LLC.
9.-SCARLET® AL-T | Spineart
Features:
- Ti-LIFE Technology
- The structure mimics the architecture of trabecular bone and is designed to promote bone ingrowth. This technology is based on a proprietary algorithm combined with a unique additive manufacturing process commonly referred to as 3D printing.
- Integrated Screw Channel
- The 3 SCARLET® AL-T screws are easily inserted into the cage thanks to the 3 channels.
- High Performance Screw
- The self-drilling screw design has a very sharp endtip with flutes and quadri threads which ease the insertion in the vertebra.
- One Step Cam Lock
- The zero-profile one-step locking mechanism with pre-assembled cam locks prevent screw migration.
10.-BIG® ST | SIGNUS
BIG® ST ALIF lumbar cage can be inserted either from anterior or minimal invasive from retro/ transperitoneal. With it ́s open porous structure BIG® ST comes along with the same excellent osteoconductive characteristics as the other implants oft he ST-Line by SIGNUS.
Besides the traditional ALIF approach, BIG® ST can also be inserted in 45° oblique or 90°lateral technique. Implanted from anterior it is possible to insert four divergent fixation screws and use it as a stand- alone fusion device which comes along with both economic benefits and less invasive surgery for the patient. With its wide range of implant sizes and lordotic angles a restoration of disc height and sagittal profile is ensured.
The flattened front edge and the smooth lateral surfaces combined with the self distracting design ensure a reduced preparation and protection of the nerval structures while inserting.The open macroporous structure resembles natural cancellous architecture and enables both – growing on and growing in of bone that can be supported by filling the implant with KAINOS® Inject.
An increased roughness in conjunction with the proven SIGNUS toothed cage design secures the anchoring in the bone owing to a high primary stability and reduces the risk of implant migration. The large contact area with the vertebral body reduces the risk of subsidence.All implants are in individual sterile packaging and for immediate use.The system is completed with sophisticated and easy-to-use instruments