Biomechanical study of a novel transoral atlantoaxial lateral mass fusion cage used for irreducible atlantoaxial dislocation
MO Shao-dong, AI Fu-zhi, LI Ke-wei, LI Ke-ke, CHEN Shu-jin
Chinese Journal of Clinical Anatomy ›› 2017, Vol. 35 ›› Issue (3) : 307-311.
Biomechanical study of a novel transoral atlantoaxial lateral mass fusion cage used for irreducible atlantoaxial dislocation
Objective To compare the stabilities of the lateral mass fusion cage and iliac crest autograft combined with Transoral Atlantoaxial Reduction Plate (TARP) system and posterior C1-C2 pedicle screw-rod system. Method Cage was designed based on the three-dimension parameters of 40 postoperative patients operated with TARP. Range of motion (ROM) in flexion-extension, left-right bending and axial rotation of 6 cadaveric specimens with different treatments were recorded. Results The measured data indicated that feasible cage design were in 3 sizes: 13/12/7/16°，12/11/7/18°，11/10/7/20°(length/width/height/sagittal angle);ROM of TARP (combined with Cage or ilium) was smaller compared with posterior C1-C2 pedicle screw-rod system and difference between left and right bending was statistically significant. Conclusion The stiffness was analogous between TARP system (combined with cage or iliac crest autograft) and posterior C1-C2 pedicle screw-rod system. Furthermore, cage combined with TARP may simplify surgeric procedure and decrease the incidence of clinical complication.
[1] Simsek S, Yigitkanli K, Belen D, et al. Halo traction in basilar invagination: technical case report[J]. Surg Neurol, 2006,66(3):311-314.
[2] Yin Q, Ai F, Zhang K, et al, Transoral atlantoaxial reduction plate internal fixation for the treatment of irreducible atlantoaxial dislocation: a 2- to 4-year follow-up[J]. Orthop Surg, 2010,2(2):149-155.
[3] Ai F, Yin Q, Wang Z, et al, Applied anatomy of transoral atlantoaxial reduction plate internal fixation[J]. Spine, 2006,31(2):128-132.
[4] Ai F, Yin Q, Xu D, et al, 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[J]. Spine, 2011,36(8):E556-562.
[5] Kandziora F, Schollmeier G, Scholz M, et al, Influence of cage design on interbody fusion in a sheep cervical spine model[J]. J Neurosurg, 2002,96(3 Suppl):321-332.
[6] Li Y, Wu Z, Li X, et al, A polycaprolactone-tricalcium phosphate composite scaffold as an autograft-free spinal fusion cage in a sheep model[J]. Biomaterials, 2014,35(22):5647-5659.
[7] Kandziora F, Schulze-Stahl N, Khodadadyan-Klostermann C, et al, Screw placement in transoral atlantoaxial plate systems: an anatomical study[J]. J Neurosurg, 2001, 95(1 Suppl):80-87.
[8] 马向阳, 尹庆水, 吴增晖, 等. 寰枢椎后路四种钉棒固定方法的三维稳定性评价[J]. 中国脊柱脊髓杂志, 2008,18(6):464-468.
[9] Panjabi M, Dvorak J, Duranceau J, et al. Three-dimensional movements of the upper cervical spine[J]. Spine,1988,13(7):726-730.
[10]田伟,安岩,李加宁,等. 斜坡枢椎角的正常值及其与延髓脊髓角的相关性研究[J]. 中华骨科杂志,2014,34(3):306-310.
[11]Dong Y, Hong M, Jianyi L, et al, Quantitative anatomy of the lateral mass of the atlas[J]. Spine, 2003,28(9):860-863.
[12]Cattrysse E, Provyn S, Gagey O, et al, In vitro three dimensional morphometry of the lateral atlantoaxial articular surfaces[J].Spine, 2008, 33(14):1503-1508.
[13]Nadim Y, Sabry F, Xu R, et al, Computed tomography in the determination of transarticular C1-C2 screw length[J]. Orthopedics, 2000,23(4):373-375.
[14]Xia H, Yin Q, Ai F, et al, Treatment of basilar invagination with atlantoaxial dislocation: atlantoaxial joint distraction and fixation with transoral atlantoaxial reduction plate (TARP) without odontoidectomy[J]. Eur Spine J, 2014,23(8):1648-1655.
[15]Yang J, Ma X, Xia H, et al, Transoral anterior revision surgeries for basilar invagination with irreducible atlantoaxial dislocation after posterior decompression: a retrospective study of 30 cases[J]. Eur Spine J, 2014,23(5): 1099-1108.
[16]Kandziora F, Pflugmacher R, Ludwing K, et al, Biomechanical comparison of four anterior atlantoaxial plate systems[J]. J Neurosurg, 2002, 96(3):313-320.
[17]石林,夏虹,赵卫东,等. 第Ⅲ代经口寰枢椎复位钢板系统三维稳定性评价[J]. 中国临床解剖学杂志, 2012,30(3):342-344.
[18]Richter M, Schmidt R, Claes L, et al, Posterior atlantoaxial fixation: biomechanical in vitro comparison of six different techniques[J]. Spine, 2002,27(16):1724-1732.
[19]Melcher R, Puttlitz C, Kleinstueck F, et al, Biomechanical testing of posterior atlantoaxial fixation techniques[J]. Spine,2002, 27(22):2435-2440.
/
| 〈 |
|
〉 |
