Clinical evaluation of a growth factor bioavailability enhanced allograft in anterior lumbar interbody fusion (ALIF)

Q: What is the purpose of evaluating GFBA in ALIF procedures?

The study evaluates a novel growth factor bioavailability-enhanced allograft (GFBA) to determine safety and efficacy in anterior lumbar interbody fusion.

Q: How were patients assessed in the 12-month postoperative period?

Participants were evaluated prospectively using computed tomography (CT), flexion-extension X-rays, and questionnaires measuring pain and disability.

Q: What fusion and pain outcomes were reported?

CT showed complete bridging in 89.1% of levels and bone growth from both end plates in 10.9%, with statistically significant improvements in low back pain and both left and right leg pain (P<0.05).

Q: Were there complications, revisions, or reoperations associated with GFBA?

No GFBA-related complications or revision/reoperations were reported in the study.

Sep 30, 2026

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Clinical evaluation of a growth factor bioavailability-enhanced allograft (GFBA) in anterior lumbar interbody fusion (ALIF) assessed fusion outcomes and patient-reported pain and disability. Consecutive consented patients treated at one site from January 2022 to December 2022 underwent prospective imaging with computed tomography (CT) and flexion-extension radiographs and completed questionnaires within 12 months postoperatively. Fifty patients (64 levels) were analyzed, with 89.1% showing 3A bridging and 10.9% 2A bridging on CT, alongside statistically significant reductions in low back and leg pain (P<0.05) and no GFBA-related complications or revisions.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Background

Methods

Results

Conclusions

Keywords

Introduction

Clinical evaluation of a growth factor bioavailability enhanced allograft in anterior lumbar interbody fusion (ALIF) Pierce D. Nunley1,2, Stacie Tran2, Marcus Stone2 1The Spine Institute of Louisiana, Shreveport, LA, USA; 2The Spine Network, Highland, UT, USA Contributions: (I) Conception and design: PD Nunley, M Stone; (II) Administrative support: PD Nunley, M Stone; (III) Provision of study materials or patients: PD Nunley, M Stone; (IV) Collection and assembly of data: S Tran; (V) Data analysis and interpretation: S Tran; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Marcus Stone, PhD. The Spine Network, 5513 W 11000 N\#422, Highland, UT 84003, [USA. Email: mstone@thespinenetwork.org](USA. Email: mstone@thespinenetwork.org). Background: Interbody fusion, especially anterior lumbar interbody fusion (ALIF), is a common treatment for spinal conditions like degenerative disc disease (DDD) . Various graft materials, including autografts, allografts, and synthetic substitutes, are used to facilitate fusion, though each has limitations. A novel growth factor bioavailability-enhanced allograft (GFBA) has been introduced, which aims to enhance fusion outcomes by unlocking critical growth factors in the bone matrix. Methods: Consecutive patients who received treatment with GFBA at a single site between January 2022 and December 2022 were invited to participate prior to 12 months postoperative assessment. Those who consented were evaluated prospectively by computed tomography (CT), flexion extension X-ray, and completed questionnaires regarding pain and disability. Results: Fifty patients (64 treated levels), with a mean age of 61.5 years old, 62.0% female, and a mean body mass index (BMI) of 31.0 kg/m2 participated. Thirty-six patients (72 .0%) underwent single level ALIF, and 14 (28.0%) underwent two-level ALIFs. All subjects (100%) had less than three degrees of motion upon flexion extension. CT scans showed complete bridging bone with no evidence of supplemental fixation failure for 89.1% of levels (defined as 3A), with the remaining 10.9% showing bone growth from both end plates and no sign of supplemental fixation failure (defined as 2A) . Statistically significant improvements were observed in low back pain (60.1 to 29.6), left leg pain (33.8 to 21.4), and right leg pain (40.2 to 18.4), all P<0.05 . No GFBA-related complications or revision/reoperations were reported. Conclusions: This study evaluated a novel GFBA and reported similar fusion rates to published reports of iliac crest bone graft (ICBG) . Significant clinical improvements and no GFBA related complications or revision/reoperations were reported. This is the first study evaluating GFBA and demonstrated its safety and efficacy in ALIF procedures for DDD. Keywords: Fusion; bone graft substitutes; Natural Matrix Protein® Fibers (NMP® Fibers); growth factor bioavailability-enhanced allograft (GFBA) Submitted Jul 19, 2025. Accepted for publication Sep 15, 2025. Published online Dec 19, 2025. doi: 10.21037/jss-25-129 View this article at: [https://dx.doi.org/10.21037/jss-25-129](https://dx.doi.org/10.21037/jss-25-129) Introduction Interbody fusion is an established treatment option for a wide range of spinal pathologies including degenerative disc disease (DDD), herniated discs, spondylolisthesis, infections, deformity, and neoplasia, with DDD being the most common diagnosis for spine fusion surgery (1) . The primary goal of interbody fusion is to provide spinal stabilization (2) . More than 400,000 cases per year are performed in the United States, making interbody fusion the most performed spinal surgery (3,4) . Further, in a 2018 report of operating room procedures, McDermott and © AME Publishing Company. J Spine Surg 2025;11(4):840-850 | [https://dx.doi.org/10.21037/jss-25-129](https://dx.doi.org/10.21037/jss-25-129) Journal of Spine Surgery, Vol 11, No 4 December

FAQs

What is the purpose of evaluating GFBA in ALIF procedures?

The study evaluates a novel growth factor bioavailability-enhanced allograft (GFBA) to determine safety and efficacy in anterior lumbar interbody fusion.

How were patients assessed in the 12-month postoperative period?

Participants were evaluated prospectively using computed tomography (CT), flexion-extension X-rays, and questionnaires measuring pain and disability.

What fusion and pain outcomes were reported?

CT showed complete bridging in 89.1% of levels and bone growth from both end plates in 10.9%, with statistically significant improvements in low back pain and both left and right leg pain (P<0.05).

Were there complications, revisions, or reoperations associated with GFBA?

No GFBA-related complications or revision/reoperations were reported in the study.

Sep 30, 2026

Uploaded by Melati