A biomechanical comparison of crossed and parallel rod configurations in atlantoaxial internal fixation

Feng, Qin; Zou, Xiaobao; Xu, Xilin; Wei-cheng, Jiang; Liu, Geng-Chao; Ma, Xiangyang

doi:10.1007/s00586-020-06655-6

Cited by 6 publications

(2 citation statements)

References 21 publications

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“…1 ) [ 29 , 30 ], HRVA ( Fig. 2 ) [ 18 , 31 ], and the presences of atlas occipitalization and C2/3 assimilation ( Fig. 3 ) were also performed to determine the characteristics of the laminar morphology and feasibility of TSP on the axis.…”

Section: Methodsmentioning

confidence: 99%

Characteristics and Comparisons of Morphometric Measurements and Computed Tomography Hounsfield Unit Values of C2 Laminae for Translaminar Screw Placement Between Patients With and Without Basilar Invagination

et al. 2022

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Objective: Patients with basilar invagination (BI) had high incidences of vertebral variations and high-riding vertebral artery (HRVA) that might restrict the use of pedicle or pars screw and increase the use of translaminar screw on axis. Here, we conducted a radiographic study to investigate the feasibility of translaminar screws and the bone quality of C2 laminae in patients with BI, which were compared with those without BI as control to provide guidelines for safe placement.Methods: In this study, a total of 410 patients (205 consecutive patients with BI and 205 matched patients without BI) and 820 unilateral laminae of the axis were included at a 1:1 ratio. Comparisons with regard to insertion parameters (laminar length, thickness, angle, and height) for C2 translaminar screw placement and Hounsfield unit (HU) values for the assessment of the appropriate bone mineral density of C2 laminae between BI and control groups were performed. Besides, the subgroup analyses based on the Goel A and B classification of BI, HRVA, atlas occipitalization, and C2/3 assimilation were also carried out. Furthermore, the factors that might affect the insertion parameters and HU values were explored through multiple linear regression analyses.Results: The BI group showed a significantly smaller laminar length, thickness, height, and HU value than the control group, whereas no significant difference was observed regarding the laminar angle. By contrast, the control group showed significantly higher rates of acceptability for unilateral and bilateral translaminar screw fixations than the BI group. Subgroup analyses showed that the classification of Goel A and B, HRVA, atlas occipitalization, and C2/3 assimilation affected the insertion parameters except the HU values. Multiple linear regression indicated that the laminar length was significantly associated with the male gender (B = 0.190, p < 0.001), diagnoses of HRVA (B = -0.109, p < 0.001), Goel A (B = -0.167, p < 0.001), and C2/3 assimilation (B = -0.079, p = 0.029); the laminar thickness was significantly associated with the male gender (B = 0.353, p < 0.001), diagnoses of HRVA (B = -0.430, p < 0.001), Goel B (B = -0.249, p = 0.026), and distance from the top of odontoid to the Chamberlain line (B = -0.025, p = 0.003); laminar HU values were significantly associated with age (B = -2.517, p < 0.001), Goel A (B = -44.205, p < 0.001), Goel B (B = -25.704, p = 0.014), and laminar thickness (B = -11.706, p = 0.001).Conclusion: Patients with BI had narrower and smaller laminae with lower HU values and lower unilateral and bilateral acceptability for translaminar screws than patients without BI. Preoperative 3-dimensional computed tomography (CT) and CT angiography were needed for BI patients.

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Section: Methodsmentioning

confidence: 99%

Characteristics and Comparisons of Morphometric Measurements and Computed Tomography Hounsfield Unit Values of C2 Laminae for Translaminar Screw Placement Between Patients With and Without Basilar Invagination

et al. 2022

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“…The atlantoaxial complex is the most mobile segment of the spine, and its range of motion (ROM) in rotation accounts for approximately 50% of the entire cervical spine rotation [ 1 ]. Atlantoaxial instability or dislocation caused by trauma, tumours, infection, and congenital malformation may lead to profound neurologic deficits and even death [ 2 ]. The goal of surgery should be to achieve reduction, decompression, fixation, and fusion of the atlantoaxial articular.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical properties of different anterior and posterior techniques for atlantoaxial fixation: a finite element analysis

Li,

Cao,

Guo

et al. 2023

J Orthop Surg Res

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Background Many techniques for atlantoaxial fixation have been developed. However, the biomechanical differences among various atlantoaxial fixation methods remain unclear. This study aimed to evaluate the biomechanical influence of anterior and posterior atlantoaxial fixation techniques on fixed and nonfixed segments. Methods An occiput-C7 cervical finite element model was used to construct 6 surgical models including a Harms plate, a transoral atlantoaxial reduction plate (TARP), an anterior transarticular screw (ATS), a Magerl screw, a posterior screw-plate, and a screw-rod system. Range of motion (ROM), facet joint force (FJF), disc stress, screw stress, and bone-screw interface stress were calculated. Results The C1/2 ROMs were relatively small in the ATS and Magerl screw models under all loading directions except for extension (0.1°–1.0°). The posterior screw-plate system and screw-rod system generated greater stresses on the screws (77.6–1018.1 MPa) and bone-screw interfaces (58.3–499.0 MPa). The Harms plate and TARP models had relatively small ROMs (3.2°–17.6°), disc stress (1.3–7.6 MPa), and FJF (3.3–106.8 N) at the nonfixed segments. Changes in disc stress and FJF of the cervical segments were not consistent with changes in ROM. Conclusions ATS and Magerl screws may provide good atlantoaxial stability. The posterior screw-rod system and screw-plate system may have higher risks of screw loosening and breakage. The Harms plate and TARP model may more effectively relieve nonfixed segment degeneration than other techniques. The C0/1 or C2/3 segment may not be more susceptible to degeneration than other nonfixed segments after C1/2 fixation.

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Osseointegration enhancement by controlling dispersion state of carbonate apatite in polylactic acid implant

Zhang,

Hayashi,

Ishikawa

2023

Colloids and Surfaces B: Biointerfaces

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A biomechanical comparison of crossed and parallel rod configurations in atlantoaxial internal fixation

Cited by 6 publications

References 21 publications

Characteristics and Comparisons of Morphometric Measurements and Computed Tomography Hounsfield Unit Values of C2 Laminae for Translaminar Screw Placement Between Patients With and Without Basilar Invagination

Characteristics and Comparisons of Morphometric Measurements and Computed Tomography Hounsfield Unit Values of C2 Laminae for Translaminar Screw Placement Between Patients With and Without Basilar Invagination

Biomechanical properties of different anterior and posterior techniques for atlantoaxial fixation: a finite element analysis

Osseointegration enhancement by controlling dispersion state of carbonate apatite in polylactic acid implant

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