Porous Cages Research Articles

Precise design, preparation, and biomechanical evaluation of customized additively manufactured Ti6Al4V porous fusion cage

Precise design, preparation, and biomechanical evaluation of customized additively manufactured Ti6Al4V porous fusion cage

Mechanochemical “Cage‐on‐MOF” Strategy for Enhancing Gas Adsorption and Separation through Aperture Matching

AbstractPost‐modification of porous materials with molecular modulators has emerged as a well‐established strategy for improving gas adsorption and separation. However, a notable challenge lies in maintaining porosity and the limited applicability of the current method. In this study, we employed the mechanochemical “Cage‐on‐MOF” strategy, utilizing porous coordination cages (PCCs) with intrinsic pores and apertures as surface modulators to improve the gas adsorption and separation properties of the parent MOFs. We demonstrated the fast and facile preparation of 28 distinct MOF@PCC composites by combining 7 MOFs with 4 PCCs with varying aperture sizes and exposed functional groups through a mechanochemical reaction in 5 mins. Only the combinations of PCCs and MOFs with closely matched aperture sizes exhibited enhanced gas adsorption and separation performance. Specifically, MOF‐808@PCC‐4 exhibited a significantly increased C2H2 uptake (+64 %) and a longer CO2/C2H2 separation retention time (+40 %). MIL‐101@PCC‐4 achieved a substantial C2H2 adsorption capacity of 6.11 mmol/g. This work not only highlights the broad applicability of the mechanochemical “Cage‐on‐MOF” strategy for the functionalization of a wide range of MOFs but also establishes potential design principles for the development of hybrid porous materials with enhanced gas adsorption and separation capabilities, along with promising applications in catalysis and intracellular delivery.

Developing Porous Protein Cage Nanoparticles as Cargo-Loadable and Ligand-Displayable Modular Delivery Nanoplatforms.

Protein cage nanoparticles, self-assembled from protein subunits, provide distinct exterior and interior spaces and can carry diagnostic and/or therapeutic cargo agents through chemical conjugation, in vitro disassembly/reassembly process, or assembly-mediated encapsulation. Here, we developed porous SpyCatcher-mi3 (SC-mi3) as modular delivery nanoplatforms, capable of loading cargos through pores and displaying targeting ligands using SpyCatchers (SC) as anchors for SpyTagged (ST) ligands. Fluorescent dyes (F5M and A647) and a pH-sensitive prodrug (Aldox) were conjugated to the interior surface cysteines of SC-mi3, forming F5M@SC-mi3, A647@SC-mi3, and Aldox@SC-mi3. Subsequently, EGFR-binding affibody molecules (EGFRAfb) were displayed on the exterior surface of F5M@SC-mi3 and Aldox@SC-mi3 using the SC/ST protein ligation system, forming F5M@mi3/EGFRAfb and Aldox@mi3/EGFRAfb, respectively. F5M@mi3/EGFRAfb selectively bound to EGFR-overexpressing MDA-MB-468 cells, visualizing the target cancer cells, while Aldox@mi3/EGFRAfb selectively delivered doxorubicin, leading to target-specific cancer cell death. To encapsulate large proteins within SC-mi3, biotins were initially conjugated to the interior surface (BPM@SC-mi3) and mSA2-fused protein cargo molecules (mSA2-HaloTag and mSA2-yCD) were successfully introduced through the pores and securely encapsulated, forming TMR-H@SC-mi3 and yCD@SC-mi3, respectively. Subsequent display of EGFRAfb on their surface allowed the visualization of target cancer cells using fluorescent HaloTag ligand labeling and facilitated the killing of target cancer cells by converting the prodrug 5-FC to the cytotoxic drug 5-FU. Modular functionalization of the two distinct spaces in porous SC-mi3 may offer opportunities for developing target-specific functional cargo-delivery nanoplatforms in biomedical fields.

Radiological evaluation of fusion patterns after Lateral Lumbar Interbody fusion with 3D-printed porous titanium cages vs. conventional titanium cages.

The assessment of segmental fusion after Lateral Lumbar Interbody fusion (LLIF) using 3D-printed porous titanium cage is still not well studied. Various criteria, such as the presence of bone bridges (BB) between adjacent vertebrae, serve as indicators for anterior fusion. However, limited radiological studies have investigated zygapophyseal joints (ZJ) status following LLIF with porous titanium cages vs. conventional titanium threaded cages. The porous design of the latest titanium intervertebral cages is thought to enhance the bone-to-implant fusion rate. This radiological study aimed to compare the fusion patterns post-LLIF using 3D-printed porous titanium cages against those using threaded titanium cages. This radiological study aimed to compare the fusion patterns after LLIF using 3D-printed porous titanium cages against those using threaded titanium cages. This retrospective, single-center radiological study involved 135 patients who underwent LLIF and posterior percutaneous screw fixation for degenerative spondylolisthesis. The study included 51 patients (Group A) with the novel porous titanium cages and 84 patients (Group B) with conventional threaded titanium cages. Inclusion criteria mandated complete radiological data and a minimum follow-up period of 24 months. The study evaluated intervertebral bone bridges (BB) for anterior fusion and zygapophyseal joints (ZJ) ankylotic degeneration, based on Pathria et al., as evidence of posterior fusion and segmental immobilization. Two years after surgery, intervertebral BB were identified in 83 segments (94.31%) in Group A and in 87 segments (88.77%) in Group B. ZJ Pathria grade I was observed in 2 segments (2.27%) of Group A and in 4 segments (4.08%) of Group B. Grade II was seen in 5 segments (5.68%) of Group A and in 6 segments (6.12%) of Group B. Posterior fusion, classified as grade III, was found in 81 segments (92.04%) of Group A and 88 segments (89.79%) of Group B. Subsidence incidence was 5.88% (3 segments) for the novel cage and 9.88% (8 segments) for the conventional cage. The architecture of porous titanium cages offers a promising solution for increasing bone ingrowth and bridging space, supporting successful spinal fusion while minimizing the risk of subsidence.

Bone ingrowth in randomly distributed porous interbody cage during lumbar spinal fusion

Porous interbody cages are often used in spinal fusion surgery since they allow bone ingrowth which facilitates long-term stability. However, the extent of bone ingrowth in and around porous interbody cages has scarcely been investigated. Moreover, tissue differentiation might not be similar around the superior and inferior cage-bone interfaces. Using mechanobiology-based numerical framework and physiologic loading conditions, the study investigates the spatial distribution of evolutionary bone ingrowth within randomly distributed porous interbody cages, having varied porosities. Finite Element (FE) microscale models, corresponding to cage porosities of 60%, 72%, and 83%, were developed for the superior and inferior interfacial regions of the cage, along with the macroscale model of the implanted lumbar spine. The implant-bone relative displacements of different porosity models were mapped from macroscale to microscale model. Bone formation of 10–40% was predicted across the porous cage models, resulting in an average Young's modulus ranging between 765 MPa and 915MPa. Maximum bone ingrowth of ∼34% was observed for the 83% porous cage, which was subject to low implant-bone relative displacements (maximum 50μm). New bone formation was found to be greater at the superior interface (∼34%) as compared to the inferior interface (∼30%) for P83 model. Relatively greater volume of fibrous tissue was formed at the implant-bone interface for the cage with 60% and 72% porosities, which might lead to cage migration and eventual failure of the implant. Hence, the interbody cage with 83% porosity appears to be most favorable for bone ingrowth, provided sufficient mechanical strength is offered.

Individualized C1-2 intra-articular three-dimensional printed porous titanium alloy cage for craniovertebral deformity

BackgroundCongenital craniovertebral deformity, including basilar invagination (BI) and atlantoaxial instability (AAI), are often associated with three-dimensional (3D) deformity, such as C1-2 rotational deformity, craniocervical kyphosis, C1 lateral inclination, among other abnormalities. Effective management of these conditions requires the restoration of the 3D alignment to achieve optimal reduction. Recently, 3D printing technology has emerged as a valuable tool in spine surgery, offering the significant advantage of allowing surgeons to customize the prosthesis design. This innovation provides an ideal solution for precise 3D reduction in the treatment of craniovertebral deformities.ObjectiveThis study aims to describe our approach to individualized computer-simulated reduction and the design of C1-2 intra-articular 3D printed porous titanium alloy cages for the quantitative correction of craniovertebral junction deformities.MethodsA retrospective analysis was conducted on patients with craniovertebral deformities treated at our institution using individualized 3D-printed porous titanium alloy cages. Preoperative CT data were used to construct models for 3D realignment simulations. Cage designs were tailored to the simulated joint morphology following computer-assisted realignment. Preoperative and postoperative parameters were statistically analyzed.ResultsFourteen patients were included in the study, with a total of 28 3D-printed porous titanium alloy cages implanted. There were no cases of C2 nerve root resection or vertebral artery injury. All patients experienced symptom relief and stable implant fixation achieved in all cases. No implant-related complications were reported.ConclusionThe use of individualized computer-simulated reduction and the design of C1-2 intra-articular 3D printed porous titanium alloy cage facilitates precise 3D realignment in patients with craniovertebral deformities, demonstrating effectiveness in symptom relief and stability.

Mechanochemical "Cage-on-MOF" Strategy for Enhancing Gas Adsorption and Separation through Aperture Matching.

Post-modification of porous materials with molecular modulators has emerged as a well-established strategy for improving gas adsorption and separation. However, a notable challenge lies in maintaining porosity and the limited applicability of the current method. In this study, we employed the mechanochemical "Cage-on-MOF" strategy, utilizing porous coordination cages (PCCs) with intrinsic pores and apertures as surface modulators to improve the gas adsorption and separation properties of the parent MOFs. We demonstrated the fast and facile preparation of 28 distinct MOF@PCC composites by combining 7MOFs with 4 PCCs with varying aperture sizes and exposed functional groupsthrough a mechanochemical reactionin 5 mins. Only the combinations of PCCs and MOFs with closely matched aperture sizes exhibited enhanced gas adsorption and separation performance. Specifically, MOF-808@PCC-4 exhibited a significantly increased C2H2 uptake (+64%) and a longer CO2/C2H2 separation retention time (+40%). MIL-101@PCC-4 achieved a substantial C2H2 adsorption capacity of 6.11 mmol/g. This work not only highlights the broad applicability of the mechanochemical "Cage-on-MOF" strategy for thefunctionalization of a wide range of MOFs but also establishes potential design principles for the development of hybrid porous materials with enhanced gas adsorption and separation capabilities, along with promising applications in catalysis and intracellular delivery.

Feasibility of the Non-Window-Type 3D-Printed Porous Titanium Cage in Posterior Lumbar Interbody Fusion: A Randomized Controlled Multicenter Trial.

Three-dimensionally printed titanium (3D-Ti) cages can be divided into 2 types: window-type cages, which have a void for bone graft, and non-window-type cages without a void. Few studies have investigated the necessity of a void for bone graft in fusion surgery. Therefore, the present study assessed the clinical and radiographic outcomes of window and non-window-type 3D-Ti cages in single-level posterior lumbar interbody fusion. A total of 70 patients were randomly assigned to receive either a window or non-window cage; 61 patients (87%) completed final follow-up (32 from the window cage group, 29 from the non-window cage group). Radiographic outcomes, including fusion rates, subsidence, and intra-cage osseointegration patterns, were assessed. Intra-cage osseointegration was measured using the intra-cage bridging bone score for the window cage group and the surface osseointegration ratio score for the non-window cage group. Additionally, we looked for the presence of the trabecular bone remodeling (TBR) sign on computed tomography (CT) images. Of the 61 patients, 58 achieved interbody fusion, resulting in a 95.1% fusion rate. The fusion rate in the non-window cage group was comparable to, and not significantly different from, that in the window cage group (96.6% and 93.8%, p > 0.99). The subsidence rate showed no significant difference between the window and non-window cage groups (15.6% and 3.4%, respectively; p = 0.262). The intra-cage osseointegration scores showed a significant difference between the groups (p = 0.007), with the non-window cage group having a higher proportion of cases with a score of 4 compared with the window cage group. The TBR sign was observed in 87.9% of patients who achieved interbody fusion, with a higher rate in the non-window cage group across the entire cohort although the difference was not significant (89.7% versus 78.1%, p = 0.385). Non-window-type 3D-Ti cages showed equivalent clinical outcomes compared with window-type cages and comparable interbody fusion rates. These results suggest that the potential advantages of 3D-Ti cages could be optimized in the absence of a void for bone graft by providing a larger contact surface for osseointegration. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

On the successful pelletization of a fragile mesoporous material and its mechanical stability mechanism

Mechanical stability is a crucial property for the industrial implementation of heterogeneous catalysts and adsorbents. Both particle size and shape need to be investigated for each application where, typically, a compromise between mass transfer and pressure drop needs to be understood. In this study, we investigate the mechanical stability of a fragile mesostructured cellular foam material, formed of 3D aluminosilicate struts and porous cages, that are connected through windows. Successful pelletization was found at ca. 20 MPa, where the structural and textural properties are either unaltered or minimally modified. This condition is satisfactory for the final application of the pelletized material, though a lower-limit pressure could still be optimized. The use of higher pelletization pressures was observed to increase disorder in the systems. The structure contracts, the cage's size decreases markedly leading to more disordered wormhole-like pores. The decrease in cage/pore size seems to compensate for the structural densification, resulting in relatively constant BET areas. The pore volume's decrease is in agreement with the smaller cage sizes and densification. The damage and the mechanism causing this damage differ from that observed in conventional mesoporous materials. Besides the successful pelletization conditions and identification of damage mechanism, it is also noteworthy to highlight that values for BET area can be misleading when assessing mechanical stability; at high pressures, the BET areas remain fairly constant despite significant changes in pore size and structure are observed.

Porous covalent cages for visualizing the adsorbed iodine and stabilizing ylide intermediates

Porous covalent cages for visualizing the adsorbed iodine and stabilizing ylide intermediates

Design and study of additively manufactured Three periodic minimal surface (TPMS) structured porous titanium interbody cage

ObjectiveTPMS porous structures have adjustable stiffness, a smooth surface, and highly connected pores, which help avoid stress concentration within the dot-matrix structure and promote cell adhesion and proliferation. A cervical interbody cage based on this type of porous structure was designed and fabricated, and its mechanical properties and biocompatibility were evaluated. MethodsTPMS porous structures have adjustable stiffness, a smooth surface, and highly connected pores, which help avoid stress concentration within the dot-matrix structure and promote cell adhesion and proliferation. A cervical interbody cage based on this type of porous structure was designed and fabricated, and its mechanical properties and biocompatibility were evaluated. ResultsThe volume fraction of the 3D-printed TC4-based Tubular-G structure was linearly related to compressive strength. Adjusting the volume fraction resulted in a Tubular-G structure with a modulus and yield strength similar to human bone, without stress concentration within the structure. The designed and fabricated TC4-based Tubular-G porous cervical interbody cage demonstrated excellent anti-sagging properties and biocompatibility. ConclusionsThe volume fraction of the 3D-printed TC4-based Tubular-G structure was linearly related to compressive strength. Adjusting the volume fraction resulted in a Tubular-G structure with a modulus and yield strength similar to human bone, without stress concentration within the structure. The designed and fabricated TC4-based Tubular-G porous cervical interbody cage demonstrated excellent anti-sagging properties and biocompatibility.

Recent progress of porous cage materials in sample preparation, chromatographic separation, and detection.

Porous cage materials with certain dimensions, sizes, shapes, and functions have been regarded as promising materials for sample preparation, chromatographic separation, and detection process. In contrast to infinite frameworks such as metal-organic frameworks or covalent organic frameworks, porous cage materials are constructed from discrete molecules containing at least one internal cavity. The well-defined cavities in porous cage materials provide opportunities for non-covalent interactions. These interactions can be programmed into the ligand design or supramolecular cage constructing using the cages as building blocks, offering various host-guest recognition with great selectivity. In this review, we desire to elucidate the fundamental principles governing the design and fabrication of porous cage materials with well-defined cavities, good solvent processability, and modifiable groups, the applications of these porous cage materials in sample preparation, chromatographic separation, and detection were discussed. The recent advantages of porous cage materials for the analysis process were summarized. We state the potential of these materials and provide an outlook for further application strategies. We expect that this review can inspire interest in the porous cage materials research area for analysis.

Biomimetic Porous Ti6Al4V Implants: A Novel Interbody Fusion Cage via Gel-Casting Technique to Promote Spine Fusion.

An interbody fusion cage (Cage) is crucial in spinal decompression and fusion procedures for restoring normal vertebral curvature and rebuilding spinal stability. Currently, these Cages suffer from issues related to mismatched elastic modulus and insufficient bone integration capability. Therefore, a gel-casting technique is utilized to fabricate a biomimetic porous titanium alloy material from Ti6Al4V powder. The biomimetic porous Ti6Al4V is compared with polyetheretherketone (PEEK) and 3D-printed Ti6Al4V materials and their respective Cages. Systematic validation is performed through mechanical testing, in vitro cell, in vivo rabbit bone defect implantation, and ovine anterior cervical discectomy and fusion experiments to evaluate the mechanical and biological performance of the materials. Although all three materials demonstrate good biocompatibility and osseointegration properties, the biomimetic porous Ti6Al4V, with its excellent mechanical properties and a structure closely resembling bone trabecular tissue, exhibited superior bone ingrowth and osseointegration performance. Compared to the PEEK and 3D-printed Ti6Al4V Cages, the biomimetic porous Ti6Al4V Cage outperforms in terms of intervertebral fusion performance, achieving excellent intervertebral fusion without the need for bone grafting, thereby enhancing cervical vertebra stability. This biomimetic porous Ti6Al4V Cage offers cost-effectiveness, presenting significant potential for clinical applications in spinal surgery.

Dual functionalized Co3O4 porous cages with Pd and Co-MOF for acetone gas sensing under high humidity

Metal oxide semiconductor (MOS) gas sensors play a crucial role in gas sensors. However, the effect of higher ambient humidity on the sensitivity of MOS gas sensors is still largely an unsolved problem, limiting the application areas of sensors. In this work, an ultra-stable and sensitive acetone gas sensor based on dual functionalized Co3O4 porous cages with Pd and Co-MOF at high humidity is reported. The dual functionalized porous cages are made of MOF-derived Co3O4 porous cages substrate, Pd particles and hydrophobic Co-MOF coatings. The prepared porous cages composite exhibits humidity-independent and highly sensitive gas-sensing behavior to acetone under 70–90 % relative humidity (RH). The results indicate that the hydrophobic Co-MOF coatings not only offer excellent anti-humidity, but also show the ability of enrichment of low concentration acetone gas molecules, thus improving the sensitivity and response time of acetone detection. Meanwhile, due to the electronic spillover effect of Pd, porous cages composite possesses remarkable properties of high sensitivity, short response and recovery time, as well as low working temperature. The unique sensing characteristic makes the dual functionalized porous cages composite sensor a potential candidate for reliable noninvasive diagnosis of diabetes via exhaled breath analyses.

Coalescence of Porous Coordination Cages into Crystalline and Amorphous Bulk Solids.

Discrete porous coordination cages are attractive as a solution processable material whose porosity is not predicated on a network structure. Here, we leverage the peripheral functionalization of these cage structures to obtain 12 novel, solution processable, porous coordination cages that afford crystalline and amorphous single-phase millimeter-scale monolithic bulk structures (six of each) upon solidification. These structures are based upon prototypal metal-organic polyhedra [Cu24(5-x-isophthalate)24] (where x = NH2, OH), wherein meta-substitution of linker ligands with acyl chloride or isocyanate moieties afforded amide and urethane functional groups, respectively. These porous cage structures were obtainable via direct synthesis between a metal salt and a ligand as well as postsynthetic modification of the cage and formed monoliths following centrifugation and drying of the product. We rationalize their self-assembly as colloidal packing of nanoscale cuboctahedral cages through weak interactions between their hydrophobic alkyl/aromatic surfaces. In general, amorphous solids were obtained via rapid precipitation from the mother liquor upon methanol addition, while crystalline solids could be obtained only following further chloroform and pyridine additions. The structure of the materials is confirmed via gas sorption and spectroscopic methods, while powder X-ray diffraction and transmission electron microscopy are used to determine the nature of these bulk solids.

Application of 3D‑printed porous titanium interbody fusion cage vs. polyether ether ketone interbody fusion cage in anterior cervical discectomy and fusion: A systematic review and meta‑analysis update.

The present study aimed to compare the differences between 3D-printed porous titanium and polyether ether ketone (PEEK) interbody fusion cages for anterior cervical discectomy and fusion (ACDF). Literature on the application of 3D-printed porous titanium and PEEK interbody fusion cages for ACDF was searched in the PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang and VIP databases. A total of 1,181 articles were retrieved and 12 were finally included. The Cochrane bias risk assessment criteria and Newcastle-Ottawa scale were used for quality evaluation and Review Manager 5.4 was used for data analysis. The 3D cage group was superior to the PEEK cage group in terms of operative time [mean difference (MD): -7.68; 95% confidence interval (CI): -11.08, -4.29; P<0.00001], intraoperative blood loss (MD: -6.17; 95%CI: -10.56, -1.78; P=0.006), hospitalization time (MD: -0.57; 95%CI: -0.86, -0.28: P=0.0001), postoperative complications [odds ratio (OR): 0.35; 95%CI: 0.15, 0.80; P=0.01], C2-7 Cobb angle (MD: 2.85; 95%CI: 1.45, 4.24; P<0.0001), intervertebral space height (MD: 1.20; 95%CI: 0.54, 1.87; P=0.0004), Japanese Orthopaedic Association Assessment of Treatment (MD: 0.69; 95%CI: 0.24, 1.15; P=0.003) and visual analogue scale score (MD: -0.43; 95%CI: -0.78, -0.07; P=0.02). The difference was statistically significant, while there was no significant difference between the two groups in terms of fusion rate (OR: 1.74; 95%CI: 0.71, 4.27; P=0.23). The use of 3D-printed porous titanium interbody fusion cage in ACDF has the advantages of short operation time, less bleeding loss, shorter hospitalization time and fewer postoperative complications. It can better maintain the cervical curvature and intervertebral height, relieve pain and accelerate postoperative functional recovery.

Biomechanical analysis of 3D printed porous extremely-low modulus Ti-24Nb-4Zr-8Sn lumbar interbody fusion cage-A finite element study

ABSTRACT This study aimed to design and assess the biomechanical properties of a 3D-printed porous titanium alloy lumbar fusion cage, comparing it to traditional PEEK cages in lumbar PLIF surgery using finite element modelling. Employing Ti-24Nb-4Zr-8Sn (Ti2448) and Ti-6Al-4 V (Ti64) materials via EBM-3D printing, the fabricated cage exhibited enhanced mechanical stability when paired with the same internal fixation system. Biomechanical analysis revealed superior performance of both Ti2448 and Ti64 porous models over PEEK, notably Ti2448. These porous titanium cages effectively mitigate maximum stress at the cage-endplate interface, ensuring uniform stress distribution and minimizing subsidence risk. Additionally, their porous structure fosters osteogenesis, while the low modulus titanium alloy, resembling human cancellous bone, enhances interbody fusion and diminishes the probability of cage subsidence.

Synthesis of Triazole-Linked Porous Cage Polymers: Modulating Cage Size for Tailored Iodine Adsorption

Synthesis of Triazole-Linked Porous Cage Polymers: Modulating Cage Size for Tailored Iodine Adsorption

Ordered porous copper sulfide with hollow interior for superior electrochemical CO2 to formate conversion

Targeted for superior formate production from electrochemical carbon dioxide (CO2) reduction, hollow ordered porous copper sulfide cuboctahedra (HOP CuS-CO) with controlled shell thicknesses were designed and synthesized in this study. Uniform and interconnected pores are evenly distributed in the hollow shells of HOP CuS-CO. Capitalizing on the merits of porous cages, HOP CuS-CO exhibit outstanding formate production with a Faradaic efficiency up to 70.3 % and catalytic stability of 26 h under an applied potential of −1.1 V versus reversible hydrogen electrode (vs. RHE). In situ Raman spectroscopy results reveal that the adsorption of HCOO* intermediates is promoted on the catalyst surfaces of HOP CuS-CO due to a spatial confinement effect, which leads to highly efficient CO2 to formate conversion. The present study offers insights for designing materials toward superior formate production from electrochemical CO2 reduction.

Interbody Fusion Device in the Treatment of Cervicobrachial Syndrome: A Prospective 5-Year Follow-Up Extension Study of Porous Titanium Cervical Cages

Background: To assess long-term clinical and radiological data of porous titanium cervical interbody cages. Methods: We recruited 34 out of 49 patients previously enrolled in the EFFECT trial on 3D printed titanium cages, for 5 years follow-up. Objectives were the evaluation of Neck Disability Index, Visual Analog Scale of arm pain and neck pain, Likert self-reported perceived recovery, EQ-5D, fusion status and subsidence. Fusion was defined as rotation ≤ 4° and ≤ 1.25 mm translation at the index level, using flexion-extension radiograph. Results: All patients had good outcomes in terms of NDI (12.5±15.4), VAS neck pain (23.5±24.1), VAS arm pain (18.7±20.2) and EuroQol (0.77±0.24). 88.6% of the patients experienced complete or nearly complete recovery. NDI improved significantly at 5 years compared to 1 year, all other outcome measures did not significantly differ from the 12 months results. The fusion rate at the index level increased from 91.5% at 12 months to 100% at 5 years. Conclusion: 3D printed stand-alone porous titanium cervical implants are effective in terms of clinical and radiological outcome with 88.6% complete or nearly complete recovery and fusion rate of 100% at 5 years follow-up. Moreover, solid single level anterior cervical fusion can be achieved without additional plating. Trial Registration: The study has been registered in The Netherlands Trial Register (NTR 1289) and approved by the Medical Ethical Committee (NL76079.058.20).