Stabilization of the atlantoaxial joint with C1-C3 lateral mass screw constructs: biomechanical comparison with standard technique. 2010

Leonardo B C Brasiliense, and Bruno C R Lazaro, and Phillip M Reyes, and Douglas Fox, and Volker K H Sonntag, and Neil R Crawford
Spinal Biomechanics Laboratory, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.

BACKGROUND Anatomically and biomechanically, the atlantoaxial joint is unique compared with the remainder of the cervical spine. OBJECTIVE To assess the in vitro stability provided by 2 C2 screw sparing techniques in a destabilized model of the atlantoaxial joint and compare with the gold standard system. METHODS The 3-dimensional intervertebral motion of 7 human cadaveric cervical spine specimens was recorded stereophotogrammetrically while applying nonconstraining, nondestructive pure moments during flexion-extension, left and right axial rotation, and left and right lateral bending. Each specimen was tested in the intact state, followed by destabilization (odontoidectomy) and fixation as follows: (1) C1 and C3 lateral mass screws rods with sublaminar wiring of C2 (LC1-C3 + SW), (2) C1 and C3 lateral mass screws rods with a cross-link in the C1-2 interlaminar space (LC1-C3 + CL), (3) C1 and C3 lateral mass screw rods alone (negative control), and (4) C1 lateral mass and C2 pedicle screws rods augmented with C1-2 interspinous wire and graft (LC1-PC2, control group). RESULTS Compared with the intact spine, each instrumented state significantly stabilized range of motion and lax zone at C1-2 (P < .001, 1-way repeated-measures analysis of variance). LC1-C3 + SW was equivalent to LC1-PC2 during flexion and lateral bending and superior to LC1-C3 + CL during lateral bending, while LC1-C3 + CL was equivalent to LC1-PC2 only during flexion. In all other comparisons, LC1-PC2 was superior to both techniques. CONCLUSIONS From a biomechanical perspective, both C2 screw sparing techniques provided sufficient stability to be regarded as an alternative for C1-2 fixation. However, because normal motion across C2-3 is sacrificed, these constructs should be used in patients with unfavorable anatomy for standard fixations.

UI MeSH Term Description Entries
D007593 Joint Instability Lack of stability of a joint or joint prosthesis. Hypermobility, Joint,Instability, Joint,Laxity, Joint,Hypermobilities, Joint,Instabilities, Joint,Joint Hypermobilities,Joint Hypermobility,Joint Instabilities,Joint Laxities,Joint Laxity,Laxities, Joint
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011300 Preoperative Care Care given during the period prior to undergoing surgery when psychological and physical preparations are made according to the special needs of the individual patient. This period spans the time between admission to the hospital to the time the surgery begins. (From Dictionary of Health Services Management, 2d ed) Care, Preoperative,Preoperative Procedure,Preoperative Procedures,Procedure, Preoperative,Procedures, Preoperative
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D001863 Bone Screws Specialized devices used in ORTHOPEDIC SURGERY to repair bone fractures. Bone Screw,Screw, Bone,Screws, Bone
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001268 Atlanto-Axial Joint The joint involving the CERVICAL ATLAS and axis bones. Atlanto Axial Joint,Atlantoaxial Joint,Atlanto Axial Joints,Atlanto-Axial Joints,Atlantoaxial Joints,Joint, Atlanto Axial,Joint, Atlanto-Axial,Joint, Atlantoaxial,Joints, Atlanto Axial,Joints, Atlanto-Axial,Joints, Atlantoaxial

Related Publications

Leonardo B C Brasiliense, and Bruno C R Lazaro, and Phillip M Reyes, and Douglas Fox, and Volker K H Sonntag, and Neil R Crawford
April 2019, Spine,
Leonardo B C Brasiliense, and Bruno C R Lazaro, and Phillip M Reyes, and Douglas Fox, and Volker K H Sonntag, and Neil R Crawford
December 2017, World neurosurgery,
Leonardo B C Brasiliense, and Bruno C R Lazaro, and Phillip M Reyes, and Douglas Fox, and Volker K H Sonntag, and Neil R Crawford
August 2006, Journal of neurosurgery. Spine,
Leonardo B C Brasiliense, and Bruno C R Lazaro, and Phillip M Reyes, and Douglas Fox, and Volker K H Sonntag, and Neil R Crawford
October 2007, Journal of spinal disorders & techniques,
Leonardo B C Brasiliense, and Bruno C R Lazaro, and Phillip M Reyes, and Douglas Fox, and Volker K H Sonntag, and Neil R Crawford
January 2020, Journal of neurosurgery. Spine,
Leonardo B C Brasiliense, and Bruno C R Lazaro, and Phillip M Reyes, and Douglas Fox, and Volker K H Sonntag, and Neil R Crawford
July 2009, The spine journal : official journal of the North American Spine Society,
Leonardo B C Brasiliense, and Bruno C R Lazaro, and Phillip M Reyes, and Douglas Fox, and Volker K H Sonntag, and Neil R Crawford
December 2021, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine,
Leonardo B C Brasiliense, and Bruno C R Lazaro, and Phillip M Reyes, and Douglas Fox, and Volker K H Sonntag, and Neil R Crawford
March 2010, Neurosurgery,
Leonardo B C Brasiliense, and Bruno C R Lazaro, and Phillip M Reyes, and Douglas Fox, and Volker K H Sonntag, and Neil R Crawford
January 2023, La Clinica terapeutica,
Leonardo B C Brasiliense, and Bruno C R Lazaro, and Phillip M Reyes, and Douglas Fox, and Volker K H Sonntag, and Neil R Crawford
November 2008, Spine,
Copied contents to your clipboard!