A curved compliant spinal bone anchor to enhance fixation strength.

Pedicle screws have long been established as the gold standard for spinal bone fixation. However, their fixation strength can be compromised in cases of low bone density, particularly in osteoporotic bone, due to the reliance on a micro-shape lock between the screw thread and the surrounding bone. T...

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Main Authors: Esther P de Kater, David J Jager, Paul Breedveld, Aimée Sakes
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0315629
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author Esther P de Kater
David J Jager
Paul Breedveld
Aimée Sakes
author_facet Esther P de Kater
David J Jager
Paul Breedveld
Aimée Sakes
author_sort Esther P de Kater
collection DOAJ
description Pedicle screws have long been established as the gold standard for spinal bone fixation. However, their fixation strength can be compromised in cases of low bone density, particularly in osteoporotic bone, due to the reliance on a micro-shape lock between the screw thread and the surrounding bone. To address this challenge, we propose augmenting conventional pedicles screws with a curved compliant anchor. This anchor integrates a curved super-elastic nitinol rod that is advanced through a canulated pedicle screw, forming a macro-shape lock within the vertebral body to aid the fixation strength. Both placement safety and fixation strength of this novel spinal bone anchor were validated on tissue phantoms (Sawbones). The radius of the curved compliant anchor's path demonstrates high precision while exhibiting strong dependence on the bone density in which the anchor is placed. When the curved compliant anchor is combined with a conventional pedicle screw, the mean maximum pull-out force elevated to 290 N, marking a 14% enhancement in pull-out resistance compared to using pedicle screw alone. Further augmentation with multiple curved compliant anchors holds promise for even greater fixation. The application of a curved compliant spinal bone anchor offers a promising means of increasing the fixation strength of pedicles screws, which is especially relevant in challenging clinical scenarios such a patient suffering from osteoporosis.
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spelling doaj-art-082129e08ae04ebfa435893e825581892025-01-08T05:33:01ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011912e031562910.1371/journal.pone.0315629A curved compliant spinal bone anchor to enhance fixation strength.Esther P de KaterDavid J JagerPaul BreedveldAimée SakesPedicle screws have long been established as the gold standard for spinal bone fixation. However, their fixation strength can be compromised in cases of low bone density, particularly in osteoporotic bone, due to the reliance on a micro-shape lock between the screw thread and the surrounding bone. To address this challenge, we propose augmenting conventional pedicles screws with a curved compliant anchor. This anchor integrates a curved super-elastic nitinol rod that is advanced through a canulated pedicle screw, forming a macro-shape lock within the vertebral body to aid the fixation strength. Both placement safety and fixation strength of this novel spinal bone anchor were validated on tissue phantoms (Sawbones). The radius of the curved compliant anchor's path demonstrates high precision while exhibiting strong dependence on the bone density in which the anchor is placed. When the curved compliant anchor is combined with a conventional pedicle screw, the mean maximum pull-out force elevated to 290 N, marking a 14% enhancement in pull-out resistance compared to using pedicle screw alone. Further augmentation with multiple curved compliant anchors holds promise for even greater fixation. The application of a curved compliant spinal bone anchor offers a promising means of increasing the fixation strength of pedicles screws, which is especially relevant in challenging clinical scenarios such a patient suffering from osteoporosis.https://doi.org/10.1371/journal.pone.0315629
spellingShingle Esther P de Kater
David J Jager
Paul Breedveld
Aimée Sakes
A curved compliant spinal bone anchor to enhance fixation strength.
PLoS ONE
title A curved compliant spinal bone anchor to enhance fixation strength.
title_full A curved compliant spinal bone anchor to enhance fixation strength.
title_fullStr A curved compliant spinal bone anchor to enhance fixation strength.
title_full_unstemmed A curved compliant spinal bone anchor to enhance fixation strength.
title_short A curved compliant spinal bone anchor to enhance fixation strength.
title_sort curved compliant spinal bone anchor to enhance fixation strength
url https://doi.org/10.1371/journal.pone.0315629
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