A biomechanical evaluation of odontoid screw plate fixation system
10.3760/cma.j.issn.0529-5815.2016.03.012
- VernacularTitle:齿状突螺钉钢板内固定系统的生物力学研究
- Author:
Yong HU
1
;
Weixin DONG
;
Xiaoyang SUN
;
Zhenshan YUAN
;
Jiao ZHANG
;
Hui XIE
;
Chunhui WU
Author Information
1. 315040,宁波市第六医院脊柱外科
- Keywords:
Fracture fixation,internal;
Cervical vertebrae;
Odontoid;
Plate;
Biomechanical
- From:
Chinese Journal of Surgery
2016;54(3):212-216
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the biomechanical stability of anterior odontoid screw plate (AOSP).Methods Eight fresh-frozen cadaveric cervical spine specimens were subjected to stepwise destabilization of the C1-Ca complex,simulating a type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,and the C2-3 disc injury.Intact specimens,fractured specimens,and fractured specimens with posterior,anterior fixation techniques were divided into six groups:control group (intact),injury group of type Ⅱ odontoid fracture and type Ⅰ Hangman fracture combined with C2-3 disk injury,after anterior cervical plate + odontoid screw + cage (ACP + OS + cage) group,after anterior odontoid screw plate (AOSP) fixation system group,after affixing rods from pedicle screws in C2 to lateral mass screws in C3 + odontoid screw (C2PS + C3LMS +OS) group,after affixing rods from pedicle screws in C1 to pedicle screws in C2 and lateral mass screws in C3 (C1 PS + C2PS + C3LMS) group.The range of motion (ROM) and neutral zone of C1-C2 and C2-C3 segment was tested.Results There was statistically significant difference between the C1PS + C2PS + C3LMS fixation group and the AOSP fixation group of ROMC1-C2 (P < 0.05).During all loading modes,AOSP + Bone graft fixation significantly outperformed the ACP + OS + cage fixation in limiting ROMC2-C3.During flexion and extension,AOSP fixation significantly outperformed the C1PS + C2PS + C3LMS fixation and C2PS + C3LMS + OS fixation in limiting ROMC2-C3.Conclusion The AOSP fixation system has excellent biomechanical performance when dealing with type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,and the C2-3 disc injury,and appear to be a safe and effective technique for dealing with the combined injury.