PLIF PEEK Lumbar Cage – Posterior Lumbar Interbody Fusion Cage and Instrument Set

The PLIF PEEK Lumbar Cage from Peak Surgicals is a posterior lumbar interbody fusion (PLIF) cage and instrument set designed to support the complete intraoperative workflow of PLIF procedures — covering disc space preparation, intervertebral height trialling across four footprint sizes and four height options, cage introduction, bone graft packing, and neural element protection during cage placement. The set contains 21 trial spacers across footprints of 20mm, 22mm, 26mm, and 32mm width at heights of 8mm, 10mm, 12mm, and 14mm, eight reamers including both standard cylindrical and tapered profiles, and dedicated PLIF instruments including a Distracter, Bone Graft Inserter, Bone Graft Cage, Cage Holder, Curette, Nerve Dissector, and Hammer, all supplied in an aluminum box. It is used by spine surgeons and neurosurgeons in hospital operating theatres performing PLIF for lumbar degenerative disc disease, lumbar spondylolisthesis, and lumbar instability requiring posterior interbody fusion.

Posterior Lumbar Interbody Fusion: Procedure and Cage Role

Posterior lumbar interbody fusion (PLIF) is a posterior spinal surgical approach in which the surgeon accesses the lumbar disc space from behind, retracting the dural sac and nerve roots medially after laminectomy and partial or complete facetectomy to create a bilateral working corridor into the intervertebral disc. Following discectomy and endplate preparation, PEEK interbody cages are inserted bilaterally into the disc space — one cage on each side — to restore disc space height, maintain lumbar lordosis, and provide structural support for bone graft compaction within the cage until solid fusion is achieved. The PEEK material of the cage provides a modulus of elasticity closer to bone than titanium, reducing stress shielding at the endplate interface and providing radiolucency that allows fusion assessment on postoperative plain radiographs and CT without metallic artefact obscuring the fusion zone. The PLIF PEEK Lumbar Cage from Peak Surgicals provides the cage trial system and instrument set required to size, introduce, and seat the PEEK cage in the prepared disc space via the posterior approach.

Trial Spacer System: 21 Trials Across Four Footprints and Four Heights

The 21 trial spacers in the set allow the surgeon to confirm the correct cage footprint and disc space height before the definitive PEEK cage is introduced. The trial system covers four footprint widths — 20mm, 22mm, 26mm, and 32mm — each available in heights of 8mm, 10mm, 12mm, and 14mm, with the exception of the 26mm footprint which includes all four heights (PS-T-009 through PS-T-017) and the 32mm footprint which includes all four heights (PS-T-018 through PS-T-021). The 20mm footprint trials (PS-T-001 through PS-T-004) cover the full height range; the 22mm footprint (PS-T-005 through PS-T-008) similarly covers 8 to 14mm. After bilateral discectomy and endplate preparation, the surgeon inserts trial spacers sequentially — beginning with the smallest footprint and height that can be passed through the posterior corridor without excessive neural retraction — until a trial is seated that restores the target disc height and provides stable bilateral endplate contact without rocking. The trial's footprint and height are then used to select the matching definitive PEEK cage.

Reamers: Standard and Tapered Profiles for Disc Space Preparation

The set includes eight reamers in two series. The standard cylindrical reamers — PS-R-011 (7mm), PS-R-012 (8mm), and PS-R-013 (9mm) — prepare the disc space by progressively enlarging the intervertebral channel from the posterior corridor to the anterior disc space, removing residual disc material and preparing the endplates for cage contact. The tapered reamers — PS-R-027 (8×6.5mm), PS-R-028 (8.5×7.5mm), PS-R-029 (9.5×8.5mm), PS-R-030 (10×10.5mm), and PS-R-031 (10.5×11.5mm) — provide the graduated taper preparation needed to create the correct disc space geometry for tapered cage introduction, where the anterior disc space must be reamed slightly wider than the posterior entry point to accommodate the cage profile without endplate fracture. Together, the two reamer series cover the full range of disc space preparation techniques used in PLIF from standard parallel cage insertion to tapered cage introduction.

PLIF-Specific Instruments: Distracter, Nerve Dissector, Cage Holder, and Bone Graft Tools

The instrument component of the set provides the dedicated tools required for safe and effective PLIF cage placement. The Distracter (PS-D-022) is used to open the disc space to the target height before trial insertion, preventing endplate fracture from forced trial introduction into an undistracted space. The Nerve Dissector (PS-ND-026) protects the dural sac and nerve roots during disc space preparation and cage introduction — in PLIF, the neural elements must be retracted medially throughout the instrument and cage insertion steps, and the nerve dissector maintains a protective barrier between the instruments and the dura during these manoeuvres. The Cage Holder (PS-CH-024) grips the PEEK cage securely for controlled introduction into the prepared disc space through the narrow posterior corridor. The Bone Graft Inserter (PS-B-014) delivers autologous bone graft or bone substitute material into the disc space before or after cage placement to fill the fusion zone within and around the cage. The Bone Graft Cage (PS-B-023) assists with graft containment and compaction. The Curette (PS-C-025) performs final endplate preparation, removing residual cartilaginous endplate material to expose the bony endplate surface required for cage osseointegration. The Hammer (PS-H-016) provides controlled impaction for final cage seating.

CE Mark, ISO 13485, and FDA Certification for Spine Implant and Instrument Procurement

The PLIF PEEK Lumbar Cage set is manufactured under CE Mark, ISO 13485, and FDA compliant quality standards. ISO 13485 certification confirms Peak Surgicals operates a documented quality management system covering design control, material traceability, and production consistency for spinal implants and surgical instruments. CE Mark confirms conformity with European medical device regulations, and FDA compliance supports procurement for US-based hospitals, spine surgery centres, and neurosurgical departments requiring verified regulatory documentation for spinal implant and instrument set purchases.

Product Specifications

Frequently Asked Questions

What is posterior lumbar interbody fusion (PLIF) and how does this cage system support it?
Posterior lumbar interbody fusion is a surgical technique in which the surgeon approaches the lumbar intervertebral disc through a posterior midline incision, performs laminectomy and medial facetectomy to access the disc space bilaterally, removes the disc, prepares the vertebral endplates, and inserts interbody cages — typically one on each side — to restore disc height, decompress the neural foramina by indirect height restoration, and provide a structural scaffold for bone fusion between the adjacent vertebral bodies. The PLIF approach is chosen for conditions including lumbar degenerative disc disease with radiculopathy or myelopathy, lumbar spondylolisthesis requiring reduction and stabilization, and lumbar instability requiring interbody support in addition to posterior pedicle screw fixation. The PLIF PEEK Lumbar Cage set from Peak Surgicals provides the trial system and dedicated instruments required to perform this procedure, from disc space distraction through to final cage seating and bone graft compaction.

Why is PEEK used for the lumbar cage material rather than titanium?
PEEK (polyether ether ketone) has an elastic modulus of approximately 3–4 GPa, which is close to the elastic modulus of cortical bone (15–25 GPa) and significantly lower than titanium (100–110 GPa). When a titanium cage is placed between two vertebral endplates, its much higher stiffness relative to bone can concentrate stress at the cage-endplate interface, potentially contributing to endplate fracture and cage subsidence. PEEK's lower modulus creates a more compliant load-sharing environment between the cage and the adjacent bone, reducing the risk of stress concentration. PEEK is also radiolucent — it does not appear on plain radiographs or CT scans — which allows direct visualisation of bone graft incorporation within the cage on postoperative imaging without the metallic artefact that obscures fusion assessment through titanium implants. For these reasons, PEEK interbody cages are widely used in lumbar interbody fusion across multiple approaches including PLIF, TLIF, ALIF, and XLIF.

How are the trial spacer footprint and height selected intraoperatively?
After bilateral discectomy and endplate preparation, the surgeon uses the Distracter (PS-D-022) to open the disc space to approximately the target restoration height. A trial spacer is then inserted using the Cage Holder through the posterior corridor, with the Nerve Dissector protecting the dural sac during the manoeuvre. The trial is assessed fluoroscopically and by tactile feel — a correctly sized trial sits flat against both endplates without rocking, fills the disc space height without requiring excessive distraction force, and does not produce an increase in neural tension on the retracted nerve root. The footprint is selected based on the width of the prepared disc space and the surgeon's preferred cage-to-endplate coverage ratio. Most standard adult lumbar levels are accommodated by the 22mm or 26mm footprints; the 20mm footprint serves smaller disc spaces or narrow corridors, and the 32mm footprint provides wider coverage for larger disc spaces.

What is the role of the tapered reamers (PS-R-027 to PS-R-031) compared to the standard reamers?
The standard cylindrical reamers (PS-R-011 to PS-R-013, 7–9mm) prepare the disc space with a consistent diameter from posterior to anterior, suited for parallel-walled cage designs that are inserted with a consistent profile throughout the disc space. The tapered reamers (PS-R-027 to PS-R-031) have a graduated taper from the posterior to the anterior diameter — for example, PS-R-027 is 8mm at the posterior end and 6.5mm at the anterior end — creating a disc space geometry that accommodates tapered cage designs which are wider anteriorly than posteriorly. Tapered cages allow a larger anterior footprint to be introduced through a smaller posterior entry point, enabling better anterior disc space coverage with less posterior neural retraction. The choice between standard and tapered reamers is determined by the cage design being used and the surgeon's technique preference.

What certifications does this set carry?
The PLIF PEEK Lumbar Cage set is manufactured under CE Mark, ISO 13485, and FDA compliant quality standards. ISO 13485 certification confirms Peak Surgicals operates a documented quality management system covering design control, material traceability, and manufacturing consistency for spinal implants and instruments. CE Mark confirms conformity with European medical device regulations, and FDA compliance supports procurement for US hospitals, spine surgery centres, and neurosurgical departments requiring verified regulatory documentation for spinal implant and instrument set purchases.

Can individual cage sizes or instruments be ordered separately?
Individual trial spacers by footprint and height designation, individual reamers by diameter (PS-R series), and individual instruments (Distracter, Cage Holder, Nerve Dissector, etc.) are available from Peak Surgicals as replacement items using their PS reference numbers. OEM manufacturing and custom set configurations are available for hospital procurement departments and spine surgery distributors requiring specific cage size matrix combinations, additional height or footprint options, or custom packaging formats. Contact Peak Surgicals directly for replacement component pricing, OEM specifications, or institutional procurement arrangements.