50 patients scheduled for transforaminal lumbar interbody fusion due to degenerative lumbar disease between L1 and S2 were included in this study to compare outcomes between different bone grafting materials. Patients were randomized to receive an autologous iliac crest bone graft or a mixture of hydroxyapatite combined with autologous bone from decompression sites. Fusion and clinical outcomes were measured over a 12-month follow-up. The fusion rate was similar between the different bone grafting materials at 12 months, both reporting an 83% fusion rate based on CT criteria. Both groups demonstrated significant improvements in VAS pain and disability (ODI), however, there were no differences between groups.