Anterior lumbar interbody fusion with a novel osteoinductive allograft – Mid-term clinical and radiographic outcomes

Objectives: Graft material can impact fusion rates in anterior lumbar interbody fusion (ALIF) procedures. We aimed to evaluate the clinical and radiographic outcomes of patients who underwent ALIF with a novel osteoinductive demineralised bone allograft (DBA) due to the paucity of peer reviewed lite...

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Main Authors: Charlie R. Faulks, Dean T. Biddau, Michael D. Selby, Ralph J. Mobbs, Gregory M. Malham
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:World Neurosurgery: X
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590139725000146
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author Charlie R. Faulks
Dean T. Biddau
Michael D. Selby
Ralph J. Mobbs
Gregory M. Malham
author_facet Charlie R. Faulks
Dean T. Biddau
Michael D. Selby
Ralph J. Mobbs
Gregory M. Malham
author_sort Charlie R. Faulks
collection DOAJ
description Objectives: Graft material can impact fusion rates in anterior lumbar interbody fusion (ALIF) procedures. We aimed to evaluate the clinical and radiographic outcomes of patients who underwent ALIF with a novel osteoinductive demineralised bone allograft (DBA) due to the paucity of peer reviewed literature. Methods: Includes 112 consecutive patients from 3 senior spine surgeons (multi-centre) undergoing stand-alone ALIF with osteoinductive DBA (Allovance® Crunch Plus) between January 1, 2019 and January 1, 2022. Patient reported outcome measures included visual analog scale (VAS) back pain, Oswestry disability index (ODI) and 12-Item Short Form Survey (SF-12) measured at preoperative, 6-week, 6-month, 12-month, and 24-month time points. CT imaging conducted postoperative day-2 for instrumentation positioning then at either 6-, 12- or 24-months for interbody fusion status. If fusion was achieved no further CTs were undertaken. Minimum follow-up was 12 months (12–24). Results: Mean age of cohort (51.8 % male) was 51.4 ± 14.1 years. Procedures consisted of; single level (n = 71), double level (n = 20), or quadruple level (n = 2) ALIF, and hybrid procedures (n = 19, disc replacement superior to ALIF). Preoperative mean VAS back (7.5 ± 1.5), and ODI (30.4 ± 7.8) significantly (p < 0.0001) decreased (2.5 ± 2.1, 12.2 ± 8.1); SF-12 physical (29.4 ± 5.7), and SF-12 mental (41.3 ± 12.2) showed improvements (p < 0.05) at 12-months follow-up (47.5 ± 8.8, 52.6 ± 7.6). Fusion was achieved at 6-months in 23.6 %, 12-months in 86.8 %, and 24-months in 93.4 % of patients. Nineteen (30.6 %) patients suffered acute (n = 8) and chronic (>6 months, n = 11) complications. Conclusions: Patients undergoing ALIF with this novel osteoinductive DBA demonstrated significant improvement in pain, disability and function with high fusion rates over 24-month follow-up.
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spelling doaj-art-de0c5d78d3a246a19c654c7f3e93467c2025-08-20T01:55:38ZengElsevierWorld Neurosurgery: X2590-13972025-04-012610044010.1016/j.wnsx.2025.100440Anterior lumbar interbody fusion with a novel osteoinductive allograft – Mid-term clinical and radiographic outcomesCharlie R. Faulks0Dean T. Biddau1Michael D. Selby2Ralph J. Mobbs3Gregory M. Malham4Neuroscience Institute, Epworth HealthCare, Melbourne, VIC, AustraliaNeuroscience Institute, Epworth HealthCare, Melbourne, VIC, Australia; School of Biomedical Science, Queensland University of Technology, Brisbane, QLD, AustraliaDiscipline of Orthopaedics and Trauma, The University of Adelaide, Adelaide, SA, Australia; Adelaide Spine and Brain, Adelaide Spine Clinic, Adelaide, SA, AustraliaNeuroSpine Surgery Research Group (NSURG), Randwick, NSW, Australia; NeuroSpine Clinic, Prince of Wales Private Hospital, Randwick, NSW, Australia; Faculty of Medicine, University of New South Wales (UNSW), Randwick, NSW, AustraliaNeuroscience Institute, Epworth HealthCare, Melbourne, VIC, Australia; Department of Surgery, University of Melbourne, Parkville, VIC, Australia; Swinburne University of Technology, Melbourne, VIC, Australia; Corresponding author. Epworth HealthCare, 89 Bridge Road, Suite 8.3, Danks Tower, Richmond, Melbourne, VIC, 3121, Australia.Objectives: Graft material can impact fusion rates in anterior lumbar interbody fusion (ALIF) procedures. We aimed to evaluate the clinical and radiographic outcomes of patients who underwent ALIF with a novel osteoinductive demineralised bone allograft (DBA) due to the paucity of peer reviewed literature. Methods: Includes 112 consecutive patients from 3 senior spine surgeons (multi-centre) undergoing stand-alone ALIF with osteoinductive DBA (Allovance® Crunch Plus) between January 1, 2019 and January 1, 2022. Patient reported outcome measures included visual analog scale (VAS) back pain, Oswestry disability index (ODI) and 12-Item Short Form Survey (SF-12) measured at preoperative, 6-week, 6-month, 12-month, and 24-month time points. CT imaging conducted postoperative day-2 for instrumentation positioning then at either 6-, 12- or 24-months for interbody fusion status. If fusion was achieved no further CTs were undertaken. Minimum follow-up was 12 months (12–24). Results: Mean age of cohort (51.8 % male) was 51.4 ± 14.1 years. Procedures consisted of; single level (n = 71), double level (n = 20), or quadruple level (n = 2) ALIF, and hybrid procedures (n = 19, disc replacement superior to ALIF). Preoperative mean VAS back (7.5 ± 1.5), and ODI (30.4 ± 7.8) significantly (p < 0.0001) decreased (2.5 ± 2.1, 12.2 ± 8.1); SF-12 physical (29.4 ± 5.7), and SF-12 mental (41.3 ± 12.2) showed improvements (p < 0.05) at 12-months follow-up (47.5 ± 8.8, 52.6 ± 7.6). Fusion was achieved at 6-months in 23.6 %, 12-months in 86.8 %, and 24-months in 93.4 % of patients. Nineteen (30.6 %) patients suffered acute (n = 8) and chronic (>6 months, n = 11) complications. Conclusions: Patients undergoing ALIF with this novel osteoinductive DBA demonstrated significant improvement in pain, disability and function with high fusion rates over 24-month follow-up.http://www.sciencedirect.com/science/article/pii/S2590139725000146AllograftAnterior lumbar interbody fusionComputed tomographyOsteoinductive allograftDemineralised bone allograftPatient reported outcome measures
spellingShingle Charlie R. Faulks
Dean T. Biddau
Michael D. Selby
Ralph J. Mobbs
Gregory M. Malham
Anterior lumbar interbody fusion with a novel osteoinductive allograft – Mid-term clinical and radiographic outcomes
World Neurosurgery: X
Allograft
Anterior lumbar interbody fusion
Computed tomography
Osteoinductive allograft
Demineralised bone allograft
Patient reported outcome measures
title Anterior lumbar interbody fusion with a novel osteoinductive allograft – Mid-term clinical and radiographic outcomes
title_full Anterior lumbar interbody fusion with a novel osteoinductive allograft – Mid-term clinical and radiographic outcomes
title_fullStr Anterior lumbar interbody fusion with a novel osteoinductive allograft – Mid-term clinical and radiographic outcomes
title_full_unstemmed Anterior lumbar interbody fusion with a novel osteoinductive allograft – Mid-term clinical and radiographic outcomes
title_short Anterior lumbar interbody fusion with a novel osteoinductive allograft – Mid-term clinical and radiographic outcomes
title_sort anterior lumbar interbody fusion with a novel osteoinductive allograft mid term clinical and radiographic outcomes
topic Allograft
Anterior lumbar interbody fusion
Computed tomography
Osteoinductive allograft
Demineralised bone allograft
Patient reported outcome measures
url http://www.sciencedirect.com/science/article/pii/S2590139725000146
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