Does pedicle screw fixation of the subaxial cervical spine provide adequate stabilization in a multilevel vertebral body fracture model? An in vitro biomechanical study.

Détails

ID Serval
serval:BIB_533DD8ECE456
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Does pedicle screw fixation of the subaxial cervical spine provide adequate stabilization in a multilevel vertebral body fracture model? An in vitro biomechanical study.
Périodique
Clinical biomechanics
Auteur(s)
Duff J., Hussain M.M., Klocke N., Harris J.A., Yandamuri S.S., Bobinski L., Daniel R.T., Bucklen B.S.
ISSN
1879-1271 (Electronic)
ISSN-L
0268-0033
Statut éditorial
Publié
Date de publication
03/2018
Peer-reviewed
Oui
Volume
53
Pages
72-78
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
Cervical vertebral body fractures generally are treated through an anterior-posterior approach. Cervical pedicle screws offer an alternative to circumferential fixation. This biomechanical study quantifies whether cervical pedicle screws alone can restore the stability of a three-column vertebral body fracture, making standard 360° reconstruction unnecessary.
Range of motion (2.0 Nm) in flexion-extension, lateral bending, and axial rotation was tested on 10 cadaveric specimens (five/group) at C2-T1 with a spine kinematics simulator. Specimens were tested for flexibility of intact when a fatigue protocol with instrumentation was used to evaluate construct longevity. For a C4-6 fracture, spines were instrumented with 360° reconstruction (corpectomy spacer + plate + lateral mass screws) (Group 1) or cervical pedicle screw reconstruction (C3 and C7 only) (Group 2).
Results are expressed as percentage of intact (100%). In Group 1, 360° reconstruction resulted in decreased motion during flexion-extension, lateral bending, and axial rotation, to 21.5%, 14.1%, and 48.6%, respectively, following 18,000 cycles of flexion-extension testing. In Group 2, cervical pedicle screw reconstruction led to reduced motion after cyclic flexion-extension testing, to 38.4%, 12.3%, and 51.1% during flexion-extension, lateral bending, and axial rotation, respectively.
The 360° stabilization procedure provided the greatest initial stability. Cervical pedicle screw reconstruction resulted in less change in motion following cyclic loading with less variation from specimen to specimen, possibly caused by loosening of the shorter lateral mass screws. Cervical pedicle screw stabilization may be a viable alternative to 360° reconstruction for restoring multilevel vertebral body fracture.
Mots-clé
Aged, Biomechanical Phenomena, Biophysics, Bone Plates, Cervical Vertebrae/diagnostic imaging, Cervical Vertebrae/physiopathology, Cervical Vertebrae/surgery, Humans, Male, Models, Biological, Pedicle Screws, Range of Motion, Articular/physiology, Research Design, Rotation, Spinal Fractures/diagnostic imaging, Spinal Fractures/physiopathology, Spinal Fractures/surgery, Spinal Fusion/instrumentation, Anterior column support, Biomechanical, Cervical, Lateral mass screw, Multilevel fracture, Pedicle screw
Pubmed
Web of science
Création de la notice
01/03/2018 21:07
Dernière modification de la notice
20/08/2019 15:08
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