Background: Titanium spine implants are well established materials in posterior spondylodesis. The biocompatibility of a semirigid tivanium cable suitable for pedicle screws in posterior spinal fusion (DDS-Plus®) was tested by a human bone marrow cell culture. In comparison to the tivanium cable implant (Ti6Al4V; DDS-Plus®), hydroxyapatite (HA), commercially pure titanium (cpTi), glass, chromium-cobalt alloy, (CrCoMo), polyaryletherketon (PAEK) and polyethylene (UHMW-PE) were tested. Materials and Methods: Scanning electron microscopy (SEM), SEM-energy dispersive X-ray analysis (SEM-EDX), fluorescent activated cell sorter (FACS), immunohistochemical techniques, light microscopy (LM) and immunochemical extracellular matrix analysis served to judge the in vitro biocompatibility of the different implants in a human bone marrow cell culture. Results: The datas of this investigation point out that the tivanium cable is equally biocompatible to commercially pure titanium and showed less signs of cytotoxicity than the other tested materials in vitro. Beside the titanium alloys, HA showed a high degree of biocompatibility compared to the polymers and CrCoMo too. Conclusions: In respect to their in vitro biocompatibility, the semirigid tivanium spine cable could be an alternative for other systems for posterior spondylodesis. Biomechanical and clinical studies are necessary to improve these datas.