To improve the osteointegration of polyetheretherketone (PEEK) spinal fusions, the 45S5 bioactive glass (R) (BG)-chitosan (CH) composite was used to coat the PEEK by a dip-coating method at room temperature. A robust bonding between the BG-CH composite coating and the PEEK was achieved by a combined surface treatment of sand blasting and acid etching. The effects of surface wettability and surface roughness on the adhesion of the BG-CH composite coating were characterized by fracture resistance (Gc), respectively, measured by four-point bending tests. Compared with the surface polar energy (wettability), the surface roughness (> 3 mu m) played a more important role for the increase in Gc values by means of crack shielding effect under the mixed mode stress. The maximum adhesion strength (sigma) of the coatings on the modified PEEK measured by the tensile pull-off test was about 5.73 MPa. The in vitro biocompatibilities of PEEK, including cell adhesion, cell proliferation, differentiation, and bioactivity in the stimulated body fluid (SBF), were enhanced by the presence of BG-CH composite coatings, which also suggested that this composite coating method could provide an effective solution for the weak PEEK-bone integration. (C) 2018 Elsevier B.V. All rights reserved.