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Research ArticleNovel Techniques & Technology

Early Experience With Novel Molded Allograft Anchors for the Management of Screw Loosening in Elderly Patients With Reduced Bone Density in Primary and Revision Lumbar Surgery

Gregory M. Malham, Dean T. Biddau, Thomas A. Wells-Quinn, Michael Selby and Geoffrey Rosenberg
International Journal of Spine Surgery October 2024, 18 (5) 630-636; DOI: https://doi.org/10.14444/8616
Gregory M. Malham
1 Neuroscience Institute, Epworth Hospital, Richmond, Melbourne, Australia
2 Swinburne University of Technology, Melbourne, Australia
3 University of Melbourne, Parkville, Victoria, Australia
BSᴄ, MB CʜB, DMᴇᴅ, FRACS
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  • For correspondence: gmalham@bigpond.net.au
Dean T. Biddau
1 Neuroscience Institute, Epworth Hospital, Richmond, Melbourne, Australia
4 Queensland University of Technology, Brisbane, Queensland, Australia
BBɪᴏᴍᴇᴅSc
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Thomas A. Wells-Quinn
1 Neuroscience Institute, Epworth Hospital, Richmond, Melbourne, Australia
MBBS
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Michael Selby
5 The International Spine Center, Adelaide, South Australia, Australia
MBBS, FRACS, FAOʀᴛʜA
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Geoffrey Rosenberg
6 St George Private Medical Center, Koogarah, New South Wales, Australia
MBBS, FRACS, FAOʀᴛʜA
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  • Figure 1
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    Figure 1

    Demineralized bone fiber anchors of different diameters. All are 30 mm in length.

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    Figure 2

    (A) A loose screw is identified intraoperatively and subsequently explanted. (B) An appropriately sized demineralized bone fiber anchor is placed into the cannulated pedicle screw tract. (C) A screw of the same diameter is then placed through the anchor.

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    Figure 3

    Demineralized bone fiber anchor insertion into a pedicle void from an explanted screw during revision surgery.

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    Figure 4

    (A–C) Preoperative computed tomography (CT) images showing pedicle screw lucencies indicative of left L5 and right S1 screw loosening. (D–F) Postoperative CT at 12 months showing reconstitution of posterior cortical and periprosthetic cancellous bone with no evidence of left L5 or right S1 screw loosening.

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    Table

    Patient demographics.

    DemographicsCounts
    No. of screws inserted with anchor50
    Women, n (%)18 (78)
    Revision procedures, n (%)18 (78)
    Age, y, mean (range)74 (67–84)
    Follow-up, mo, mean (range)15 (12–20)
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International Journal of Spine Surgery
Vol. 18, Issue 5
1 Oct 2024
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Early Experience With Novel Molded Allograft Anchors for the Management of Screw Loosening in Elderly Patients With Reduced Bone Density in Primary and Revision Lumbar Surgery
Gregory M. Malham, Dean T. Biddau, Thomas A. Wells-Quinn, Michael Selby, Geoffrey Rosenberg
International Journal of Spine Surgery Oct 2024, 18 (5) 630-636; DOI: 10.14444/8616

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Early Experience With Novel Molded Allograft Anchors for the Management of Screw Loosening in Elderly Patients With Reduced Bone Density in Primary and Revision Lumbar Surgery
Gregory M. Malham, Dean T. Biddau, Thomas A. Wells-Quinn, Michael Selby, Geoffrey Rosenberg
International Journal of Spine Surgery Oct 2024, 18 (5) 630-636; DOI: 10.14444/8616
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Keywords

  • allograft
  • augmentation
  • elderly
  • fiber anchor
  • lumbar
  • pedicle screw
  • reduced bone density
  • revision
  • screw loosening
  • spine

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