Professor Gregory Cunningham’s presentation from the Neurospine Institute.
Researchers explored an increasingly relevant question in modern spine surgery:
Can synthetic bone graft substitutes safely reduce allograft requirements while maintaining successful fusion outcomes in 3D-printed titanium interbody cages?
As lumbar fusion procedures continue to increase worldwide, so too does the focus on optimising graft selection. Despite advances in implant design and the introduction of highly porous, bioactive titanium cages, pseudarthrosis and implant failure remain significant clinical challenges.
The research team set out to evaluate whether a combination of Adbone® and Actifuse® could partially replace allograft within these newer cage designs while maintaining strong fusion outcomes.
Why Are Surgeons Looking at Synthetic Graft Substitutes?
The presentation highlighted several ongoing considerations associated with traditional grafting approaches:
- Procedure costs continue to rise
- Allograft availability can be limited
- Graft volume requirements may be substantial
- Patient preferences can influence graft selection
At the same time, the adoption of 3D-printed porous titanium cages has created new opportunities for biologic and synthetic graft combinations capable of supporting bone formation and fusion within highly osteoconductive implant structures.
The Study
Researchers retrospectively reviewed lumbar fusion cases performed between 2021 and 2025.
The investigation compared:
- 64 patients (112 levels) receiving allograft alone
- 32 patients (42 levels) receiving a combination of Adbone® and Actifuse® with reduced allograft volume
Fusion was assessed using CT imaging at 12 months following surgery.
Key Findings
The Adbone® and Actifuse® group demonstrated encouraging outcomes.
At L5/S1:
- Higher rates of Grade 1 (complete) fusion
- Lower rates of Grade 3 (incomplete) fusion
- No increase in complication rates
Similar positive trends were also observed at L4/L5.
Importantly, patient demographics and complication profiles were comparable between both groups.
A Synergistic Effect
Australian Allografts is proud to distribute Actifuse® and Adbone®, helping surgeons access synthetic graft solutions designed to complement modern spinal fusion techniques and evolving implant technologies.
As evidence continues to emerge, studies such as this provide valuable insight into how synthetic graft substitutes can be integrated into contemporary fusion strategies.
Data presented by Professor Greg Cunningham and colleagues from the Neurospine Institute, Curtin University, St John of God Hospital and Mount Hospital.