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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\u003C0.05) and no GFBA-related complications or revisions.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/clinical-evaluation-of-a-growth-factor-bioavailability-enhanced-allograft-in-anterior-lumbar-interbody-fusion-alif/450935/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/clinical-evaluation-of-a-growth-factor-bioavailability-enhanced-allograft-in-anterior-lumbar-interbody-fusion-alif/450935.png","ImageObject",300,407,{"name":92,"@type":93},"Melati","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What is the purpose of evaluating GFBA in ALIF procedures?","Question",{"text":112,"@type":113},"The study evaluates a novel growth factor bioavailability-enhanced allograft (GFBA) to determine safety and efficacy in anterior lumbar interbody fusion.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were patients assessed in the 12-month postoperative period?",{"text":117,"@type":113},"Participants were evaluated prospectively using computed tomography (CT), flexion-extension X-rays, and questionnaires measuring pain and disability.",{"name":119,"@type":110,"acceptedAnswer":120},"What fusion and pain outcomes were reported?",{"text":121,"@type":113},"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\u003C0.05).",{"name":123,"@type":110,"acceptedAnswer":124},"Were there complications, revisions, or reoperations associated with GFBA?",{"text":125,"@type":113},"No GFBA-related complications or revision/reoperations were reported in the study.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},450935,1791032194,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":143,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149,"preview_page_count":4},962085570644,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Clinical evaluation of a growth factor bioavailability enhanced allograft in anterior lumbar interbody fusion (ALIF)  \nPierce D. Nunley1,2, Stacie Tran2, Marcus Stone2  \n1The Spine Institute of Louisiana, Shreveport, LA, USA; 2The Spine Network, Highland, UT, USA  \nContributions: (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  \nwriting: All authors; (VII) Final approval of manuscript: All authors.  \nCorrespondence 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).  \nBackground: 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  \noutcomes by unlocking critical growth factors in the bone matrix.  \nMethods: 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  \ncompleted questionnaires regarding pain and disability.  \nResults: 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  \nP\u003C0.05 . No GFBA-related complications or revision/reoperations were reported.  \nConclusions: 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  \nefficacy in ALIF procedures for DDD.  \nKeywords: Fusion; bone graft substitutes; Natural Matrix Protein® Fibers (NMP® Fibers); growth factor  \nbioavailability-enhanced allograft (GFBA)  \nSubmitted Jul 19, 2025. Accepted for publication Sep 15, 2025. Published online Dec 19, 2025.  \ndoi: 10.21037/jss-25-129  \nView this article at: [https://dx.doi.org/10.21037/jss-25-129](https://dx.doi.org/10.21037/jss-25-129)  \nIntroduction  \nInterbody 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  \nthe 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  \n© 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)  \nJournal of Spine Surgery, Vol 11, No 4 December","cbCaiuvY9UhorMne","https://ap.wps.com/l/cbCaiuvY9UhorMne","pdf",708877,11,"English","# Background\n# Methods\n# Results\n# Conclusions\n# Keywords\n# Introduction","[{\"question\":\"What is the purpose of evaluating GFBA in ALIF procedures?\",\"answer\":\"The study evaluates a novel growth factor bioavailability-enhanced allograft (GFBA) to determine safety and efficacy in anterior lumbar interbody fusion.\"},{\"question\":\"How were patients assessed in the 12-month postoperative period?\",\"answer\":\"Participants were evaluated prospectively using computed tomography (CT), flexion-extension X-rays, and questionnaires measuring pain and disability.\"},{\"question\":\"What fusion and pain outcomes were reported?\",\"answer\":\"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\\u003c0.05).\"},{\"question\":\"Were there complications, revisions, or reoperations associated with GFBA?\",\"answer\":\"No GFBA-related complications or revision/reoperations were reported in the study.\"}]","Clinical evaluation of a growth factor bioavailability enhanced allograft in anterior lumbar interbody fusion (ALIF) | PDF",1790734103,28]