A new reconstruction procedure reinforcing endplates using fibula and transpedicular impaction bone allograft for pseudarthrosis in patients with osteoporosis after lumber body fusion surgery

Abstract

Surgical intervention for pseudarthrosis after lumbar body fusion surgery in patients with osteoporosis is complicated and difficult. We treated 3 such cases using transpedicular impaction allogenic bone graft to increase the strength of the augmented pedicle screws and processed fibula to reinforce the endplate. All cases achieved bony fusion without loosening or pulling out of the screws and subsidence of cages. Augmentation of pedicle screw fixation with allogenic bone grafts and fibula plates is an alternative option for reconstruction surgery. Furthermore, instrumentation and fusion with this augmentation technique together with the fibula plate offer a possible primary surgery to treat patients with reduced bone quality due to severe osteoporosis and for avoiding pseudarthrosis.