Spinal fixation is currently a standard of care for patients suffering from traumatic and chronic injuries that lead to reduced mobility and increased pain in the back, neck, and limbs.  New manufacturing technologies such as additive manufacturing (AM) are becoming more popular in the production of orthopedic devices, such as spinal fixation devices, due to inherent benefits that include a potentially larger set of mechanical design options that are enabled by the production of parts derived directly from the part design without dedicated tooling.  4WEB Medical’s proprietary Truss Implant Technology™ is one such example.  The U.S. Food and Drug Administration (FDA) approved titanium additively manufactured Truss Implant Technology™, which leverages a mechanobiologic mechanism inherent to its truss design that could stimulate an osteogenic response to facilitate fusion in the spine and provide joint stability during the healing, or fusion, process.Despite the popularity and proven clinical significance of AM truss implants, many questions in terms of accuracy, quality, strength, and reliability of AM parts remain relatively unanswered and therefore challenge manufacturers of medical devices.  These challenges lead manufacturers to ask the following question: “What are the differences between my design and the part that is actually manufactured, and how will these differences affect real performance?”Today, manufacturing companies typically rely on 3D imaging techniques such as industrial computed tomography (CT) for inspection and reverse engineering of AM parts.  From the CT scan data, users can typically quantify porosity, crack or defect size, and dimensional deviations from the design geometry.  However, this information, in and of itself, does not necessarily convey how these defects and deviations may affect the AM parts’ functional performance in real-world applications.  We will describe a proof-of-concept workflow intended to better understand the functional differences between as-designed and as-built AM truss implants. The workflow begins with CT imaging of the manufactured part, followed by 3D image-based measurements, and finite element (FE) simulations. We will then compare these results with the computer-aided design (CAD) model, i.e., the base design, through geometric analyses, simulations, and physical test results.  This workflow allows users to close the design loop, better understand how defects (e.g., porosity, cracks, delamination etc.) as well as dimensional deviations in the manufactured parts may affect the performance of AM devices, particularly in medicine, and potentially adjust the additive manufacturing process or the design itself to minimize functional differences.