Titan Spine, headquartered in Mequon, Wisconsin, has announced that a review of nanoLOCK surface technology titled “Spine Implant Surface Technology State of the Art: Separating Fact From Fiction” has been published in the journal Spine.
New Research Titan Spine’s nanoLOCK Implants

According to the company, “nanoLOCK is the company’s next-generation surface technology featuring enhanced micro and nano-scaled architecture, proven to significantly improve the osteogenic response it creates. It is the only technology with an FDA-nano-clearance and the only technology with a Centers for Medicare & Medicaid Services (CMS) new technology category designation for a nanotechnology surface.”
“The review of research shows that the company’s titanium nanotextured (10–9m) surface, engineered through a proprietary subtractive process, directly interacts with cells on a molecular level to generate specific cellular responses to drive bone production that porous or micron-scale (10–6m) implant surfaces cannot. Furthermore, it shows that the combination of the implant material and the nano-scale surface is critical to the ability to stimulate bone formation.”
Titan Spine Chief Medical Officer Paul J. Slosar, M.D., commented, “There has been a substantial increase in the promotion of surface-enhanced interbody devices over the past few years, most of which are backed by unsubstantiated marketing claims rather than by science.”
“I felt the time was right to review the previously-published studies that point to one irrefutable fact—the only way to communicate to a patient’s cells in a meaningful way to drive bone growth is to combine titanium and the correct nano-architecture that only Titan Spine’s nanoLOCK surface possesses.”
“We are just now starting to produce clinical outcome data to determine if faster patient healing can be tied to the in-vitro findings summarized in this most-recent article. We look forward to publishing the data in the near future.”
Dr. Slosar, told OTW, “Titan Spine’s nanoLOCK technology is differentiated by the wealth of published literature that supports it. The research clearly shows that nanoLOCK creates an environment that favors osteogenesis while mitigating inflammation.”
“I presented several abstracts at the recent spine meetings which provided clear improved outcome data with Titan Spine’s original surface. We recently began clinical outcomes analysis on the nanoLOCK data, generated by the CMS Section X new technology code and other sources, and the early results look very positive. We look forward to sharing that data soon.”
Asked what sort of questions they received at the meetings, he told OTW, “My colleagues often ask me if the Titan Spine basic science research translates to improved clinical outcomes. I can affirm that it does indeed.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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