Anterior Transdiscal Axial Screw Fixation for Subaxial Cervical Spine: A Biomechanical Study
| Autor: | Qu Dongbin, Qingan Zhu, Lin Zou, Zhiping Huang, Minghui Zheng, Wei Ji |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_treatment Bone Screws Couple 03 medical and health sciences Fixation (surgical) 0302 clinical medicine Discectomy Humans Medicine Posterior longitudinal ligament 030212 general & internal medicine Range of Motion Articular Aged business.industry Neutral zone Anatomy Middle Aged Decompression Surgical musculoskeletal system Cervical spine Biomechanical Phenomena Spinal Fusion Cervical Vertebrae Surgery Neurology (clinical) business Range of motion Cadaveric spasm Bone Plates 030217 neurology & neurosurgery Diskectomy |
| Zdroj: | World Neurosurgery. 110:e459-e464 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2017.11.008 |
| Popis: | Objective To evaluate stability of anterior transdiscal axial screw (ATAS) fixation for anterior instrumentation and to compare with standard anterior cervical decompression and fusion and plate (ACDFP) fixation in human subaxial cervical spine. Methods Flexibility tests were conducted on 7 cadaveric specimens (C5-T1) in an intact and injured state and instrumented with ACDFP fixation, ATAS fixation, and ACDFP plus ATAS fixation at the C6-7 segment after section of the anterior and posterior longitudinal ligaments and discectomy. A pure moment of ±2.0 N-m was applied to the specimen in flexion-extension, lateral bending, and axial rotation. Range of motion (ROM) and neutral zone were calculated for the C6-7 segment. Results ROM was reduced significantly compared with the intact or injured condition for 3 configurations under all motions. ATAS fixation resulted in similar ROM in C6-7 compared with ACDFP fixation in flexion (2.7° vs. 2.6°, P = 0.419), extension (2.7° vs. 2.1°, P = 0.152), and lateral bending (4.6° vs. 4.2°, P = 0.295) but larger ROM in axial rotation (6.1° vs. 5.3°, P = 0.014). When combined with an anterior plate, ATAS fixation reduced ROM to 1.2° in flexion, 1.1° in extension, 3.3° in lateral bending, and 3.8° in axial rotation, which were significantly smaller than ACDFP or ATAS fixation alone. Conclusions ATAS fixation is a biomechanically effective alternative or supplemental method of anterior fixation in subaxial cervical spine. |
| Databáze: | OpenAIRE |
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