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

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. 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). 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. 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.