Comparative Experimental Study of Custom Made Plate for Anterior Stabilization and Dorsal Fixation Systems at C1-C2 Vertebrae Level

Abstract

Experimental study on the evaluation of strength of fixation with metal constructions at the level of C1-C2 vertebrae was performed on the basis of test laboratory for orthopaedic and traumatologic products. Experiments were performed on the cadaver block preparation (4) and plastic models (8) of craniovertebral spine. Authors’ custom made plate, hook system, screw systems by Magerl and Harms were used as fixators. First step was the imitation of the turning of the head to the right (“twisting”), second step - imitation of head tilting forward (“three point pressure”). It was shown that by its strength and stability of craniovertebral segment the elaborated metal plate was not inferior to dorsal fixation systems.

Keywords

experiment / dorsal fixation system / anterior stabilization / craniovertebral segment / strength of fixation

References

[1] 1. Ветрилэ С.Т., Колесов С.В. Краниовертебральная патология. М.: Медицина; 2004: 191-200.

[2] 2. Есин И.В. Хирургия повреждений краниовертебральной области: Дис. … канд. мед. наук. М.; 2006.

[3] 3. Луцик A.A., Раткин И.К., Никитин М.Н. Кранивертебральные повреждения и заболевания. Новосибирск; 1998.

[4] 4. Шкарубо А.Н. Хирургия опухолей основания черепа с использованием трансназального и трансорального доступов с эндоскопическим контролем (аденомы гипофиза, краниофарингиомы, хордомы): Дис. … д-ра мед. наук. М.; 2007: 21-49.

[5] 5. Lu B., He X., Zhao C.-G., Li H.-P., Wang D. Biomechanical study of artificial atlanto-odontoid joint. Spine (Phila Pa 1976). 2009; 34 (18): 1893-9.

[6] 6. Ai F.Z., Yin Q.S., Xu D.C., Xia H., Wu Z.H., Mai X.H. Transoral atlantoaxial reduction plate internal fixation with transoral transpedicular or articular mass screw of c2 for the treatment of irreducible atlantoaxial dislocation: two case reports. Spine (Phila Pa 1976). 2011; 36 (8): E556-E562.

[7] 7. Grob D., Jeanneret В., Aebi M., Markwalder T. Atlanto-axial fusion with transarticular screw fixation. J. Bone Joint Surg. Br. 1991; 73 (6): 221-7.

[8] 8. Hajek P.D., Lipka J., Hartline P., Saha S., Albright J.A. Biomechanical study of Cl-C2 posterior arthrodesis techniques. Spine (Phila Pa 1976). 1993; 18 (2): 173-177.

[9] 9. Jenzenszky D., Fecete T.F., Melcher R., Harms J. С2 prosthesis anterior upper cervical fixation device to reconstruct the second cervical vertebra. Eur. Spine J. 2007; 16 (10): 1695-1700.

[10] 10. Kandziora F., Kerschbaumer F., Starker M., Mittlmeier T. Biomechanical assessment of transoral plate fixation for atlantoaxial instability. Spine (Phila Pa 1976). 2000; 25 (12): 1555-61.

[11] 11. Kerschbaumer F., Kandziora F., Klein C., Mittlmeier T., Starker M. Transoral decompression, anterior plate fixation, and posterior wire fusion for irreducible atlantoaxial kiphosis. Spine (Phila Pa 1976). 2000; 25 (20): 2708-15.

[12] 12. El Masry M.A., El Assuity W.I., Sadek F.Z., Salah H. Two methods of atlantoaxial stabilisation for atlantoaxial instability. Acta Orthop. Belg. 2007; 73 (6): 741-6.

[13] 13. Platzer P., Eipeldauer S., Leitgeb J., Aldrian S., Vécsei V. Biomechanical comparison of odontoid plate fixation versus odontoid screw fixation. J. Spinal Disord. Tech. 2011; 24 (3): 164-9.

[14] 14. Cai X., He X., Li H., Wang D. Total atlanto-odontoid joint arthroplasty system: a novel motion preservation device for atlantoaxial instability after odontoidectomy. Spine (Phila Pa 1976). 2013; 38 (8): E451-7.

[15] 15. Vergara P., Bal J.S., Hickman Casey A.T., Crockard H.A., Choi D. C1-C2 posterior fixation: are 4 screws better than 2? Neurosurgery. 2012; 71 (1 Suppl Operative): 86-95.

[16] 16. Сикилинда В.Д., Акопов В.И., Хлопонин П.А. и др. Подготовка тканей экспериментальных животных и человека для биомеханических и морфологических исследований: Методические рекомендации. Ростов-на-Дону - Санкт-Петербург; 2002.

[17] 17. Kim Y.J., Lenke L.G., Bridwell K.H., Cho Y.S., Riew K.D. Free hand pedicle screw placement in the thoracic spine is it safe? Spine (Phila Pa 1976). 2004; 29 (3): 333-42.

[18] 18. Sar C., Elarp L. Transoral resection and reconstruction for primary osteogenic sarcoma of the second cervical vertebra. Spine (Phila Pa 1976). 2001; 26 (17): 1936-41.

[19] 19. Yin Q., Ai F., Zhang K., Xia H., Wu Z., Quan R., Mai X., Liu J. Irreducible anterior atlantoaxial dislocation: one-stage treatment with a transoral atlantoaxial reduction plate fixation and fusion. Spine (Phila Pa 1976). 2005; 30 (13): E375-81.

[20] 20. Hu Y., Dong W.X., Kepler C.K., Yuan Z.S., Sun X.Y., Zhang J., Xie H. A novel anterior odontoid screw plate for C1-C3 internal fixation. Spine (Phila Pa 1976). 2016; 41 (2): E64-72.

[21] 21. Jeanneret В., Magerl F., Stanisic M. Thrombosis of the vertebral artery - a rare complication following traumatic spondylolisthesis of the second cervical vertebra. Spine (Phila Pa 1976). 1986; 11 (2): 179-82.

[22] 22. Song G.S., Theodore N., Dickman C.A., Sonntag V.K.H. Unilateral posterior atlanto-axial transarticular screw fixation. J. Neurosurg. 1997; 87: 851-855.

[23] 23. Dickman С A., Foley K., Sonntag V.K.H., Smith M.M. Cannulated screws for odontoid screw fixation and atlanto-axial transarticular screw fixation: technical note. J. Neurosurg. 1995; 83: 1095-1100.

[24] 24. Cotler J.M., Simpson J.M., Howard S.An., Silveri C.P. Surgery of spinal trauma. Philadelphia; 2000.

RIGHTS & PERMISSIONS

Eco-Vector