Biomechanical research on posterior flexible fixation at atlantoaxial joint

Tong Jie, Ji Wei, Huang Zhiping, Zhou Ruozhou, Fang Zuozhong, Zhu Qingan

doi:10.13418/j.issn.1001-165x.2022.1.14

Chinese Journal of Clinical Anatomy >

2022 , Vol. 40 >Issue 1: 72 - 77

DOI: https://doi.org/10.13418/j.issn.1001-165x.2022.1.14

Biomechanical research on posterior flexible fixation at atlantoaxial joint

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1. Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; 2. Department of Spine Surgery, Affiliated Chenzhou Hospital, The First School of Clinical Medicine, Southern Medical University(The First People’s Hospital of Chenzhou), Chenzhou 423000, Hunan Province, China

Received date: 2020-06-04

Online published: 2022-01-19

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Abstract

Objectives To analyze the influence of thin rod and PEEK rod on the stability of the atlantoaxial joint. Methods A series of in vitro biomechanical tests were performed using six fresh adult cervical spines (occipital bone-C4 segment) to simulate different conditions in surgery including the (1) intact state; (2) injury state: type II odontoid process fracture; (3) rigid fixation: All atlantoaxial pedicle screws were connected by titanium rods with a diameter of 3.5 mm; (4) PEEK rod: atlantoaxial pedicle screws were connected by a PEEK rod with a diameter of 3.5 mm; (5) thin rod: atlantoaxial pedicle screws were connected by a thin rod with a diameter of 2.0 mm. Biomechanical studies of samples were performed under intact, injury and various fixation statements using a spinal testing machine, while applying a constant moment of 1.5 Nm in flexion-extension, left-right lateral bending, and left-right axial rotation directions. A repeated measurement design was employed in all tests. Movement were measured consecutively by an Optotrak Certus 3D measurement system in order to analyze the range of motion (ROM) and neutral zone (NZ) of atlantoaxial joint. Results In the atlantoaxial joint, ROM of fixation segments were significantly reduced in all directions when a 3.5 mm diameter titanium rod, a 2.0 mm diameter titanium rod, and a 3.5 mm diameter PEEK rod was used (P<0.05). There were no significant differences in ROM of fixation segments for rigid fixation and 2.0 mm diameter titanium rod in all directions (P>0.05). In lateral bending, ROM of the PEEK rod was significantly larger compared with rigid fixation (P=0.005). NZs of fixation segments for rigid fixation, 2.0 mm diameter titanium rod, and a 3.5 mm diameter PEEK rod fixation were significantly reduced (P<0.05). There were no significant differences among these fixations (P>0.05). Conclusions In the atlantoaxial joint, stability of using 2.0 mm diameter titanium rod fixation was comparable to rigid fixation, but stability of using PEEK rod fixation was weaker in the lateral bending direction.

Key words： Atlas;　Axis;　Posterior; ; ; Flexible fixation;　Biomechanics

Cite this article

Tong Jie, Ji Wei, Huang Zhiping, Zhou Ruozhou, Fang Zuozhong, Zhu Qingan . Biomechanical research on posterior flexible fixation at atlantoaxial joint[J]. Chinese Journal of Clinical Anatomy, 2022 , 40(1) : 72 -77 . DOI: 10.13418/j.issn.1001-165x.2022.1.14

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