Spine DegenerationFibergraftNCT07199075
Rate of Bone Union After Surgery With Stand-alone Fibergraft
An observational study of Spine Degeneration and Spine Disorder, run by AO Innovation Translation Center at 1 site in Netherlands.
Trial summary
Some people have back problems caused by degenerative conditions or instability of the spine (eg. Spondylolisthesis). These problems can lead to pain, nerve issues, or difficulties in walking. A common treatment is a type of back surgery called lumbar interbody fusion, which helps stabilize the spine. At the St. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Spine Degeneration, Spine Disorder, Spine Pain
- What is being tested?
- Questionnaires and Computer Tomography
- Type of treatment
- Surgery or procedure, Lifestyle or therapy programme
- How many people
- 80 participants
- Where
- 1 siteNetherlands
- Study dates
- 31 Oct 2025to 30 May 2026
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patients with spinal degenerative deseases from the St Mateenskliniek
Who may be able to join
- Adults ≥ 18 years old
- Diagnosed with the following lumbar spine disorders: foraminal nerve root compression, isthmic spondylolisthesis, and short-segment (1-2 levels) deformity.
- Undergone primary surgery of ALIF or XLIF using titanium cages filled with standalone Fibergraft and with the following criteria fulfilled (ie, the index surgery):
- ALIF (up to 2 levels) as either standalone (ie, no posterior procedure) or as an anterior first procedure with posterior procedure as a second procedure.
- XLIF (up to 2 levels) as an anterior first procedure with posterior procedure as a second procedure.
- Consenting to have CT scans taken to allow assessment of fusion status at 12-24 months post index surgery
Show all 10Show fewer
- This criterion is applicable to patients who have not undergone revision surgery.
- For patients who have undergone revision surgery due to any reason other than nonunion, which typically occurs within 1 year of the index surgery, this criterion is only applicable if it is possible to obtain the CT scan within 12-24 months of the index surgery. If no CT scan can be taken during this window, the patient does not need to undergo the CT scan; in such cases, the CT scan that has been taken as part of the standard of care before the revision surgery will be retrospectively retrieved to assess the fusion status at the time of the revision surgery.
- This criterion is not applicable to patients who underwent revision surgery due to nonunion, which typically occurs 1 year after the index surgery; these patients do not need to undergo the CT scan. In such cases, the CT scan that has been taken as part of the standard of care before the revision surgery will also be retrospectively retrieved to assess and grade the fusion status at the time of the revision surgery.
- Ability to provide informed consent according to the IRB/EC defined and approved procedures
Who cannot join
- Revision surgery
- Standalone XLIF
- Posterior lumbar interbody fusion
- Diagnosis of fractures, malignancies, ankylosing spondylitis, or acute cauda equina syndrome
- Diagnosis of Parkinson's disease
- Body mass index > 35kg/m2
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Netherlands1 site
St Mateenskliniek
Ubbergen, 6574
Rinse Meester, MD, +31 616076494, r.meester@maartenskliniek.nl
Robert Jan Kroeze, MD, PhD, +31 624927037, r.kroeze@maartenskliniek.nl
About this study
Official title: Fusion Rate of Anterior Lumbar Interbody Fusion and Extreme Lateral Interbody Fusion Using Titanium Cages Filled With Stand-alone Fibergraft in Lumbar Spinal Fusion
Some people have back problems caused by degenerative conditions or instability of the spine (eg. Spondylolisthesis). These problems can lead to pain, nerve issues, or difficulties in walking. A common treatment is a type of back surgery called lumbar interbody fusion, which helps stabilize the spine.
At the St. Maartenskliniek in the Netherlands, doctors have been using a special material called Fibergraft Bioactive Glass Putty for such surgeries since 2023. This material helps bones grow and heal, and it's placed inside the spine without needing extra bone from another part of the body.
This study will look at how well this material works by evaluating how many patients' bones successfully healed after surgery using this material. It will also look at how patients feel and recover after the procedure
Read the detailed description
Lumbar interbody fusion is an established procedure for patients with lumbar degenerative conditions and spondylolisthesis, with symptoms of pain, radiculopathy, and/or myelopathy. Completion of fusion, ie, union, of an intended motion segment remains a desirable endpoint of spinal fusion, supported by the observations that pseudoarthrosis, ie, nonunion, following spinal fusion is correlated with poorer patient outcomes.
Iliac crest bone autograft is considered the gold standard for spinal fusion with excellent fusion rates and clinical outcomes. However, its clinical use has been restricted due to limited availability of harvestable bone, donor-site morbidity, increased surgical time, and the need for additional surgical staff and associated costs. As a result, there has been great interest in the search for bone graft substitutes to replace or reduce the amount of autograft, which will lower the risks associated with the harvesting procedure while still providing a favorable environment for a solid fusion. A wide range of synthetic bone grafts have been explored, including ceramics, bioactive glasses, and polymer-based compounds.
Although bioactive glasses have been used in spinal fusion for three decades, literature on them is dispersed over the wide array of bioactive glasses investigated and numerous small clinical studies. There is marked variability in these studies in terms of the patient population, indications, procedures performed, single- vs multi-level procedures, types of bioactive glasses, use of autografts, duration of follow-up (FU), and methods to determine fusion status. It is therefore difficult to draw conclusions on the optimal bioactive glass for a particular application. Nonetheless, the current literature suggests that bioactive glasses may be effective as bone graft extenders when combined with autograft to promote spinal fusion, yielding at least noninferior fusion rates when compared with autograft alone. There is limited data regarding the effectiveness of bone glasses as standalone bone graft substitutes or in interbody fusion procedures.
This single-center study to be conducted at the St. Maartenskliniek, the Netherlands, aims to address this knowledge gap. Since 2023, the hospital has consistently used Fibergraft Bioactive Glass (BG) Putty, a product from the FIBERGRAFTTM Bioactive Bone Graft Substitute family (Johnson \& Johnson MedTech), as standalone cage fillers for anterior lumbar interbody fusion (ALIF) and extreme lateral interbody fusion (XLIF). This provides an opportunity for a case series to determine the fusion rate for bioactive glass as a standalone bone graft substitute in lumbar interbody fusion.
- Conditions
- Spine Degeneration, Spine Disorder, Spine Pain, Spine Fusion, Spine Fusion for Degenerative Spine Disease, Nerve Root Compress;Lumbosac
- Being tested
- Questionnaires, Computer Tomography
- Medical subject headings
- Spinal Diseases, Spondylolisthesis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
QuestionnairesBehavioural
Questionnaires
- Oswestry Disability Index (ODI)
- Pain NRS lower back and (wors side) leg
- EQ-5D-3L
Computer TomographyRadiation
One additional CT scan is performed for some patients
What is being measured
The primary outcome is the main question the study is designed to answer.
Interbody fusion status
The primary outcome measure is the interbody fusion status determined by a regular lumbar spine CT scan protocol without additional radiation or contrast agents. The patients will be evaluated with one CT-scan within a window of 12 to 24 months postsurgery. The Bridwell Interbody Fusion Grading Classification will be used to assess fusion status for each intended segment.
Measured: 12months to 24th months after index surgery
Secondary outcomes (6)
Oswestry Disability Index (ODI)
The level of disability will be measured using the ODI . The ODI is a self-administered questionnaire divided into ten sections designed to assess limitations of various activities of daily living. Each section is scored on a 0-5 scale, with 5 representing the greatest disability. The index is calculated by dividing the sum of the scores by the total possible score, which is then multiplied by 100 and expressed as a percentage. The preoperative ODI will be retrospectively collected via medical records, and patients will fill out the ODI at the 12-24 months visit.
Measured: Before the index surgery and 12-24months post index surgery
General back pain and (worse side) leg pain
General back pain and (worse side) leg pain will be measured by the patients on an NRS of 0 to 10, with 0 representing no pain and 10 the worst imaginable pain.
Preoperative pain NRS will be retrospectively collected via medical records, and patients will fill out pain NRS at the 12-24 months visit.
Measured: Before the index surgery and 12-24 months after the index surgery
The EuroQoL-5 Dimension
The EQ-5D is a generic measure of self-reported health developed by the EuroQol Group. It measures five dimensions for describing health states: mobility, usual activities, self-care, pain and discomfort, and anxiety and depression. The questionnaire is comprised of two parts. The first part is the EQ-5D descriptive system, in which individuals are asked to indicate the level of problem they experience on each of the five dimensions. The second part is the EQ Visual Analogue Scale, which captures the individual's overall health on a scale from 0 (worst health imaginable) to 100 (best health imaginable). For this study, the EQ-5D-3L (3 levels) version will be used.
Preoperative EQ-5D-3L will be retrospectively collected via medical records, and patients will fill out EQ-5D-3L at the 12-24 months visit.
Measured: Before the index surgery and 12-24months after the index surgery
Patient's overall satisfaction
Patients' overall satisfaction with the treatment will be measured on a 7-point Likert scale at the 12-24 months visit.
- Extremely satisfied
- Very satisfied
- Somewhat satisfied
- Mixed (approximately equal satisfaction and dissatisfaction)
- Somewhat dissatisfied
- Very dissatisfied
- Extremely dissatisfied
Measured: 12months to 24th months after the index surgery
Complications
The following AEs/complications are of particular interest to the study. The dates when they occur and their treatments (reoperation, medical treatment, or no interventions) will be documented:
- Dural tear (if the patient has undergone posterior procedure)
- Persistent radiculopathy
- Sensory deficit
- Motor deficit
- Persistent back pain
- Cauda syndrome (if the patient has undergone posterior procedure)
- Retrograde ejaculation (for male patients)
- Vascular injury (if the patient has undergone anterior procedure)
- Hardware failure
- Pseudoarthrosis
- Persistent wound leakage
- Surgical wound infection (superficial)
- Surgical wound infection (deep)
- Deep vein thrombosis
- Pulmonary embolism
- Pneumonia
- Urinary tract infection
- Other, specify
In addition to postoperative complications, several radiographic findings and the date of detection on images will also be recorded:
- Cage subsidence
- If yes, levels of cage subsidence (multiple answers possible): T12-L1 to L5-S1
- For
Measured: From after the index surgery until the visit at 12months to 24months after the index surgery
Reoperations
Any reoperation of the index levels and the adjacent levels, such as revision, removal of implants, and supplemental fixation, will be documented
Measured: From after the index surgery until the 12months to 24months visit after the index surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Sep 2025
- Study start31 Oct 2025 (estimated)
- Primary completion30 May 2026 (estimated)
- Study completion30 May 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Spine DegenerationStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 80 participants (estimated)
Sponsor and investigators
- Lead sponsor
- AO Innovation Translation Center
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07199075
- Sponsor's protocol ID
- Fibergraft
- Acronym
- Fibergraft
- Status last verified
- Sep 2025
- First submitted
- 22 Sep 2025
- Last updated
- 30 Sep 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: All IPD collected for this study
Study at a glance
From the registry record, last updated by the sponsor on 30 Sep 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Fusion Rate of Anterior Lumbar Interbody Fusion and Extreme Lateral Interbody Fusion Using Titanium Cages Filled With Stand-alone Fibergraft in Lumbar Spinal Fusion
- ClinicalTrials.gov ID
- NCT07199075
- Acronym / sponsor ID
- Fibergraft / Fibergraft
- Conditions
- Spine Degeneration, Spine Disorder, Spine Pain, Spine Fusion, Spine Fusion for Degenerative Spine Disease, Nerve Root Compress;Lumbosac
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 80 participants (estimated)
- Lead sponsor
- AO Innovation Translation CenterUniversity, hospital or other
- Study start
- 31 Oct 2025 (estimated)
- Primary completion
- 30 May 2026 (estimated)
- Study completion
- 30 May 2026 (estimated)
- First posted
- 30 Sep 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Some people have back problems caused by degenerative conditions or instability of the spine (eg. Spondylolisthesis). These problems can lead to pain, nerve issues, or difficulties in walking. A common treatment is a type of back surgery called lumbar interbody fusion, which helps stabilize the spine.
At the St. Maartenskliniek in the Netherlands, doctors have been using a special material called Fibergraft Bioactive Glass Putty for such surgeries since 2023. This material helps bones grow and heal, and it's placed inside the spine without needing extra bone from another part of the body.
This study will look at how well this material works by evaluating how many patients' bones successfully healed after surgery using this material. It will also look at how patients feel and recover after the procedure
Detailed description
Lumbar interbody fusion is an established procedure for patients with lumbar degenerative conditions and spondylolisthesis, with symptoms of pain, radiculopathy, and/or myelopathy. Completion of fusion, ie, union, of an intended motion segment remains a desirable endpoint of spinal fusion, supported by the observations that pseudoarthrosis, ie, nonunion, following spinal fusion is correlated with poorer patient outcomes.
Iliac crest bone autograft is considered the gold standard for spinal fusion with excellent fusion rates and clinical outcomes. However, its clinical use has been restricted due to limited availability of harvestable bone, donor-site morbidity, increased surgical time, and the need for additional surgical staff and associated costs. As a result, there has been great interest in the search for bone graft substitutes to replace or reduce the amount of autograft, which will lower the risks associated with the harvesting procedure while still providing a favorable environment for a solid fusion. A wide range of synthetic bone grafts have been explored, including ceramics, bioactive glasses, and polymer-based compounds.
Although bioactive glasses have been used in spinal fusion for three decades, literature on them is dispersed over the wide array of bioactive glasses investigated and numerous small clinical studies. There is marked variability in these studies in terms of the patient population, indications, procedures performed, single- vs multi-level procedures, types of bioactive glasses, use of autografts, duration of follow-up (FU), and methods to determine fusion status. It is therefore difficult to draw conclusions on the optimal bioactive glass for a particular application. Nonetheless, the current literature suggests that bioactive glasses may be effective as bone graft extenders when combined with autograft to promote spinal fusion, yielding at least noninferior fusion rates when compared with autograft alone. There is limited data regarding the effectiveness of bone glasses as standalone bone graft substitutes or in interbody fusion procedures.
This single-center study to be conducted at the St. Maartenskliniek, the Netherlands, aims to address this knowledge gap. Since 2023, the hospital has consistently used Fibergraft Bioactive Glass (BG) Putty, a product from the FIBERGRAFTTM Bioactive Bone Graft Substitute family (Johnson \& Johnson MedTech), as standalone cage fillers for anterior lumbar interbody fusion (ALIF) and extreme lateral interbody fusion (XLIF). This provides an opportunity for a case series to determine the fusion rate for bioactive glass as a standalone bone graft substitute in lumbar interbody fusion.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients with spinal degenerative deseases from the St Mateenskliniek
Key inclusion criteria (10 listed)
- Adults ≥ 18 years old
- Diagnosed with the following lumbar spine disorders: foraminal nerve root compression, isthmic spondylolisthesis, and short-segment (1-2 levels) deformity.
- Undergone primary surgery of ALIF or XLIF using titanium cages filled with standalone Fibergraft and with the following criteria fulfilled (ie, the index surgery):
- Consenting to have CT scans taken to allow assessment of fusion status at 12-24 months post index surgery
- Ability to provide informed consent according to the IRB/EC defined and approved procedures
Key exclusion criteria (6 listed)
- Revision surgery
- Standalone XLIF
- Posterior lumbar interbody fusion
- Diagnosis of fractures, malignancies, ankylosing spondylitis, or acute cauda equina syndrome
- Diagnosis of Parkinson's disease
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| QuestionnairesQuestionnaires * Oswestry Disability Index (ODI) * Pain NRS lower back and (wors side) leg * EQ-5D-3L | Behavioural | – |
| Computer TomographyOne additional CT scan is performed for some patients | Radiation | – |
Primary outcome
Interbody fusion status
Time frame: 12months to 24th months after index surgery
The primary outcome measure is the interbody fusion status determined by a regular lumbar spine CT scan protocol without additional radiation or contrast agents. The patients will be evaluated with one CT-scan within a window of 12 to 24 months postsurgery. The Bridwell Interbody Fusion Grading Classification will be used to assess fusion status for each intended segment.
6 secondary outcomes
Oswestry Disability Index (ODI)
Time frame: Before the index surgery and 12-24months post index surgery
General back pain and (worse side) leg pain
Time frame: Before the index surgery and 12-24 months after the index surgery
The EuroQoL-5 Dimension
Time frame: Before the index surgery and 12-24months after the index surgery
Patient's overall satisfaction
Time frame: 12months to 24th months after the index surgery
Complications
Time frame: From after the index surgery until the visit at 12months to 24months after the index surgery
Reoperations
Time frame: From after the index surgery until the 12months to 24months visit after the index surgery
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Sep 2025.
- Individual participant dataSharing planned: Yes. All IPD collected for this study
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Spine Degeneration and Spine Disorder, run by AO Innovation Translation Center at 1 site in Netherlands.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 30 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Netherlands. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Marco Minoia (+41 (0)79 612 09 67, marco.minoia@aofoundation.org), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Interbody fusion status (time frame: 12months to 24th months after index surgery). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Sep 2025.