Biomechanical evaluation of anterior cervical spine stabilization. 1998

M R Grubb, and B L Currier, and J S Shih, and V Bonin, and J J Grabowski, and E Y Chao
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota, USA.

METHODS An in vitro biomechanical study. OBJECTIVE To simulate a severe compressive flexion injury for determination of the relative stability of different anterior instrumentation systems in a porcine model and to validate this model in human cadaveric specimens. BACKGROUND Anterior plate fixation is useful for high-grade mechanical insufficiency of the cervical spine and may prevent the need for a second procedure. METHODS The cervical spines of 45 porcine and 12 cadaveric specimens were subjected to nondestructive flexion, lateral bending, and torsional testing on a modified universal testing machine. A corpectomy was performed with release of the posterior ligamentous structures. The specimens were stabilized with one of three anterior plate constructs. The nondestructive testing was repeated to evaluate structural stability (stiffness and neutral zone). Finally, destructive testing examined failure moment, energy to failure, and mechanism of failure. RESULTS The instrumented specimens had flexural and lateral bending and torsional stiffness values that were similar to or greater than those of their paired intact specimens. The cervical spine locking plate had a significantly higher flexural stiffness ratio (plated:intact), torsional stiffness ratio, lower flexural neutral zone ratio, higher failure moment, and higher energy to failure than did the Caspar plate. CONCLUSIONS The cervical spine locking plate is theoretically safer than the Caspar system because the posterior vertebral body cortex is not breached by the fixation screws, and the screws are less likely to back out anteriorly and irritate the esophagus. According to these results, the cervical spine locking plate system is biomechanically equivalent to and in some cases more stable than the Caspar system for fixation of a severe compressive flexion injury.

UI MeSH Term Description Entries
D007796 Laminectomy A surgical procedure that entails removing all (laminectomy) or part (laminotomy) of selected vertebral lamina to relieve pressure on the SPINAL CORD and/or SPINAL NERVE ROOTS. Vertebral lamina is the thin flattened posterior wall of vertebral arch that forms the vertebral foramen through which pass the spinal cord and nerve roots. Laminotomy,Laminectomies,Laminotomies
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001860 Bone Plates Implantable fracture fixation devices attached to bone fragments with screws to bridge the fracture gap and shield the fracture site from stress as bone heals. (UMDNS, 1999) Bone Plate,Plate, Bone,Plates, Bone
D001863 Bone Screws Specialized devices used in ORTHOPEDIC SURGERY to repair bone fractures. Bone Screw,Screw, Bone,Screws, Bone
D002102 Cadaver A dead body, usually a human body. Corpse,Cadavers,Corpses
D002574 Cervical Vertebrae The first seven VERTEBRAE of the SPINAL COLUMN, which correspond to the VERTEBRAE of the NECK. Cervical Spine,Cervical Spines,Spine, Cervical,Vertebrae, Cervical
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
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia

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