40 patients scheduled for one- or two-level transforaminal lumbar interbody fusion (TLIF) were randomized to have the procedures completed using a polyetheretherketone cage with or without a titanium spray coating (TiPEEK and PEEK groups). Patients were assessed for clinical outcomes on the Oswestry Disability Index, back and leg pain on a visual analog scale, and Euro-QoL 5-dimensions (EQ-5D) questionnaire, as well as fusion on CT over a 12-month follow-up. Results demonstrated no significant differences between groups in ODI or VAS back pain after 3, 6, or 12 months, as well as VAS leg pain after 3 or 6 months; by 12 months, back pain was significantly greater in the TiPEEK group compared to the PEEK group. The rate of complete fusion and partial fusion by 6 months did not significantly differ between groups.