Biomechanical analysis of anterior cervical spine plate fixation systems with unicortical and bicortical screw purchase

Lehmann, Wolfgang; Blauth, M.; Briem, D.; Schmidt, Ulf

doi:10.1007/s00586-003-0578-z

Cited by 11 publications

(21 citation statements)

References 31 publications

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“…Currently, many surgeons are applying unicortical screw fixation resulting in fairly good outcomes. However, there also have been few reports insisting bicortical screws that provided better outcome 12) . Therefore, in the anterior fixation group of bilateral interfacetal dislocation with posterior ligament injury, more strength for stabilization may be required, and that bicortocal insertion would provide better stabilization.…”

Section: Discussionmentioning

confidence: 99%

The Management of Bilateral Interfacetal Dislocation with Anterior Fixation in Cervical Spine : Comparison with Combined Antero-Posterior Fixation

Kim

Cho

Sung

2007

J Korean Neurosurg Soc

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Section: Discussionmentioning

confidence: 99%

The Management of Bilateral Interfacetal Dislocation with Anterior Fixation in Cervical Spine : Comparison with Combined Antero-Posterior Fixation

Kim

Cho

Sung

2007

J Korean Neurosurg Soc

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“…Zahlreiche Arbeiten haben sich mit den mechanischen Eigenschaften der verschiedenen Stabilisationssysteme und den damit erreichten klinischen Ergebnissen beschäftigt [7,14,19,20,21,36,40,41,42,56,61]. Trotz kontroverser Aussagen scheint sicher zu sein, dass die klinischen Ergebnisse durch die kombinierte Verwendung eines Plattensystems mit einem den Diskusraum straff füllen-den Platzhalter (Cage, "strut graft", Kompositgraft) wesentlich verbessert wurden [3,4,10,11,13,16,18,28,29,37,38,39,50,52,60].…”

Section: Diskussionunclassified

“…Ein winkelinstabiles oder dynamisches Plattensystem [7,14,19,20,21,40,41,42] lässt im Interface zwischen Schraubenkopf und Platte drei Arten von Bewegungen zu: F Rotation ("pivoting"), F Wanken ("toggling"), F Verschiebung ("translocation").…”

Section: Winkelinstabile Plattensystemeunclassified

“…Die Qualität und Quantität der Stabilität wird durch die mechanischen Eigenschaften des verwendeten Osteosynthesematerials und durch die Qualität des eigenen Knochens entschieden [7,14,19,20,21,36,40,41,42,56,61]. Die Vaskularität wird von der körpereigenen örtlichen Gewebequalität und besonders von der Art des eingesetzten Transplantatsmaterials/ Ersatzmaterials beeinflusst [8,47,58].…”

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“…Sie findet zwar, genauso wie das Knochenmark [30,62], in Kombination mit verschiedenen "Kraftträgern" [3,20,16,18,23,28,31,45,62] zur Anregung der Knochenneubildung ihre beschränkte Anwendung und die damit gewonnenen Ergebnisse werden als positiv bezeichnet, ihre alleinige Verwendung bei Anfertigung der vorderen Plattenspondylodesen, sicherlich wegen der minderwertigen mechanischen Eigenschaften, wurde jedoch Die jetzt vorliegende Arbeit ist die erweiterte Version eines Referats, welches in Salzburg (10. bis 11. März 2006) während des 42.…”

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Vordere Spondylodesen an der unteren Halswirbelsäule

Sándor

Barzó

Kuncz

et al. 2008

Chirurg

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Physical alterations in cervical fusions endanger healing. Experimentally we determined less stability loss in fixations using cancellous bone grafts than in those using tricortical grafts. Four hundred eighty-five Patients underwent anterior cervical fusion, for a total of 700 Segments. Patients were divided into four groups: (1) nonlocked H plate with autogenous cancellous bone, (2) nonlocked H plate with autogenous tricortical graft, (3) locked cervical plate with tricortical graft, and (4) stand-alone cage with cancellous bone. Evaluations included X-ray and random CT scan examinations. Our results suggest that anterior cervical fusions using nonlocked H screw plate systems with pure autogenous cancellous bone grafts provide the fastest (6 weeks) and most secure bone healing (P=0.00001), whereas fixations using nonlocked or locked screw plate systems and tricortical autograft require prolonged healing and develop nonunions more frequently. Complete consolidation was achieved using stand-alone cages filled with pure autogenous cancellous bone, but bony healing was delayed due to the cage. Rate of nonunions were: groups 1 and 4 0%, and groups 2 and 3 4.5% and 21%, respectively.

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Biomechanical comparison of anterior cervical spine locked and unlocked plate-fixation systems

et al. 2004

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Three different anterior plate-fixation systems are available for the stabilisation of the cervical spine: (1) the cervical spine locking plate (CSLP), (2) dynamic plates allowing vertical migration of the fixation screws, and (3) various types of plates that are secured with either monocortical or bicortical unlocked screws. Unicortical screw purchase does not involve the risk of posterior cortex penetration and possible injuries to the spinal cord. The development of locking plates with unicortical screw-fixation and intrinsic stability of the screw-plate interface, via an angle-stabilised connection, was an attempt to increase the stability of unicortical screw-fixation systems. The aim of the study was to compare the biomechanical properties of a non-locking, anterior-plate system with 4.5 mm screw fixation and a locking anterior-plate system, in a single destabilised cervical spine-motion segment. Using fresh cadaveric cervical spine specimen C3-C7, multidirectional flexibility was measured at the C4-C5 level in an unconstrained test system, before and after destabilisation and fixation with an anterior plate with either locked or unlocked screw purchase. Direct comparison of the fixed cervical spine segments with unlocked and locked anterior-plate fixation did not demonstrate significant differences. This in vitro study documented that neither locked nor unlocked anterior-plate fixation can increase stability in all modes of testing. H-plate spondylodesis with unlocked screws seems to provide sufficient mechanical integrity in most cases of monosegmental lesions.

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Biomechanical analysis of anterior cervical spine plate fixation systems with unicortical and bicortical screw purchase

Cited by 11 publications

References 31 publications

The Management of Bilateral Interfacetal Dislocation with Anterior Fixation in Cervical Spine : Comparison with Combined Antero-Posterior Fixation

The Management of Bilateral Interfacetal Dislocation with Anterior Fixation in Cervical Spine : Comparison with Combined Antero-Posterior Fixation

Vordere Spondylodesen an der unteren Halswirbelsäule

Biomechanical comparison of anterior cervical spine locked and unlocked plate-fixation systems

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