Outcomes comparison between novel hydroxyapatite enhanced polyetheretherketone and titanium implants after anterior lumbar interbody fusion

Surface-enhanced PEEK and titanium ALIF implants demonstrated high fusion rates, low rates of subsidence and reoperation, and clinically meaningful improvements in disability and back pain at 12 months. These results suggest that modern surface-enhanced interbody implants may mitigate the historical nonunion risk of untreated PEEK and subsidence risk of untreated titanium, allowing implant selection to be guided by surgeon preference and case-specific factors rather than performance.