24 patients were included in this blinded, pilot, randomized clinical trial to evaluate a novel synthetic peptide, B2A, combined with ceramic granules and local bone autograft. Patients were randomized into one of three groups; either B2A at differing concentrations (750 or 150) combined with ceramic granules and local bone autograft at, or to iliac crest bone grafting. The results of this trial over a 12-month postoperative follow-up period indicated that patients in all three groups demonstrated similar rates of radiographic fusion and improvements in pain and disability. Additional clinical trials that utilize larger patient populations are needed before conclusions can be made regarding the use of B2A in this patient population.