Unexpected findings on CT scan after use of ABM/P-15 as a bone substitute for anterior lumbar interbody fusion - 02/12/25

Doi : 10.1016/j.otsr.2025.104553

Carlos Aleman ^a,^b,^c, Nicolas Ross ^a,^b, Philippe Phan ^d, Alexandre Dhenin ^a, Matthieu Vassal ^a, Guillaume Lonjon ^a,⁎

^a Orthosud Montpellier; Clinique Saint Jean Sud de France, Montpellier, France

^b Hospital Privado Universitario de Córdoba, Córdoba, Argentina

^c Hôpitaux Universitaires de Strasbourg, Strasbourg, France

^d Division of Orthopaedics Surgery, The Ottawa Hospital, Ottawa, ON, Canada

^⁎ Corresponding author at: Orthosud Rachis; Clinique Saint Jean Sud de France, Saint Jean de Vedas 34430, France. Orthosud Rachis; Clinique Saint Jean Sud de France Saint Jean de Vedas 34430 France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 02 December 2025

Abstract

Background

Anterior lumbar interbody fusion (ALIF) is an alternative for treating spine pathologies. Bone substitutes are increasingly used to enhance fusion and minimize iliac graft harvest complications. Despite numerous options, no gold standard exists. After we started using anorganic bone matrix/15-amino acid peptide fragment (ABM/P-15), we observed unexpected abnormal findings on postoperative CT scan. Our study aimed to investigate this matter: is ABM/P-15 associated with a higher rate of these findings than other substitutes? Do they impact fusion or clinical outcomes?

Hypothesis

We hypothesized that the use of ABM/P-15 was associated with more unexpected findings, potentially impacting fusion or clinical outcomes.

Patients and methods

This retrospective study included patients undergoing ALIF between 2020 and 2022, divided into two groups: one having received ABM/P-15 and the other different bone substitutes (InductOS, TBF, MagnetOs, ß gel). Unexpected findings (migration or calcification) and fusion rates were evaluated on postoperative (3- and 12-month) CT scan. Clinical outcomes (Oswestry Disability Index (ODI) and pain) were also measured.

Results

Among 152 patients (76 per group), unexpected findings were more prevalent with ABM/P-15 [40 patients (53%) vs 1 (1%); p < 0.001]. Regardless, both groups were similar in fusion rates at 1 year [72 patients (95%) vs 68 (89%); p = 0.367] and clinical outcomes (ODI decrease: 17 vs 19 points, p = 0.491).

Conclusion

ABM/P-15 showed a higher incidence of unexpected findings (calcification or product migration) than other bone substitutes, with no impact in fusion success or clinical outcomes.