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September 3, 2026JOR SpineOpen Access

Are Ceramic Cages an Option for Lumbar Interbody Fusion? A Comparative Biomechanical Numerical Study

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Authors

DNDavide NinarelloLBLuigi La Barbera

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Overview

Numerical simulation study reveals ceramic cages stabilize the lumbar spine while reducing bone strain, suggesting a lower risk of cage subsidence.

Key Points

  • To assess the biomechanical viability and mechanical performance of a commercial bioceramic interbody cage relative to conventional titanium cages in lumbar interbody fusion.
  • Validated an intact L4–L5 functional spine unit finite element model under pure moments and combined physiological loading conditions.
  • Simulated posterior lumbar interbody fusion (PLIF) and extreme lateral interbody fusion (XLIF) procedures to evaluate bioceramic versus titanium cages under postoperative loading.
  • Both PLIF and XLIF configurations stabilized the functional spine unit, achieving over a 70% reduction in range of motion.
  • Ceramic cages withstood physiological loads with zero predicted failure in PLIF and minimal interface failure (< 0.6%) in XLIF.
  • Ceramic cages significantly reduced adjacent vertebral strain compared with titanium, lowering subsidence risk without overloading the posterior fixation system.

Cite This Study

Ninarello et al. (2026) studied this question.

synapsesocial.com/papers/6a99355b636c6408cfa7d80chttps://doi.org/10.1002/jsp2.70215
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