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  • Ilsa Webeck

HD LifeSciences and Titan Lead the Pack of 3D Printed Interbody Devices Based on Radiographic Imagin

The battle for a leadership position in 3D printed spine products goes on. Manufacturers must offer products that meet the surgeons’ needs with improved scaffolds and surface area for bony growth, ideal pore characteristics and appropriate mechanical properties, but what about visualization? Advanced manufacturing methodologies are less relevant if intraoperative visualization and post-operative evaluation for fusion are more challenging than ever.

To determine the top ranked commercially available 3D printed interbody fusion devices, MedTech Strategies conducted a short online survey with 24 US-based orthopedic surgeons. Surgeons were asked to choose their preferred commercially available 3D printed devices, based on visualization, in the following radiographic images. See Figure 1.


The devices provided were:

Stryker Tritanium®

Titan ENDOSKELETON®

HD LifeSciences™ Hive™

4Web Truss System™


Figure 1: Radiographic images from tested devices


Surgeons were asked to rank devices in order of preference and a Preference Score was created from these choices. Preference Points were assigned to each device such that devices preferred first were assigned 3 points, second were assigned 2 points, third were assigned 1 point and fourth were assigned 0 points, for a maximum of 72 points possible (points multiplied by 24 respondents). The resulting total points were converted to a percentage to compare to the other devices and a Friedman statistical analysis was run to confirm the rankings of the devices. Comparison between device Preference Scores are significant (p<0.001), indicating a measurable difference in surgeon preference between devices.


Figure 2: Percent of Preference Points


HD LifeSciences received 82% of all possible Preference Points, followed by Titan (71%), 4Web (38%) and lastly Stryker who received only 10% of possible Preference Points. A high of 79% of respondents placed the Tritanium device as the least preferred device.

Additionally, more often than not, respondents that currently use interbody products from large manufacturers preferred the radiographic properties of the HD LifeSciences device over the other options (DePuy Synthes – 71%, Stryker – 80%, Globus – 57% and Zimmer – 100%). Medtronic users were split evenly between HD and Titan.


Figure 3: Market Share Leaders


Niche users also preferred HD LifeSciences, with all three users who have experience with Alphatec, Medicrea and Precision Spine choosing Hive over the other options. Users of NuVasive and K2M preferred Titan, however, as did Titan and 4WEB users.

As manufacturers utilize improved manufacturing techniques and compete for leadership positions, they must continue to evaluate their devices on all relevant factors, including preference on visualization. On this point, HD LifeSciences’ Hive wins the day.

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