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Biomechanical evaluation of occipitocervical fixation devices
C E Sutterlin1, J R Bianchi, D N Kunz
1Florida Foundation for Research in Spinal Disorders, 720 NW 11th Place, Gainesville, FL 32605, U.S.A.
Journal of Spinal Disorders
|June 5, 2001
Summary
Modern occipitocervical fixation systems offer greater stiffness than traditional wiring. Plate systems showed higher stiffness in extension and torsion, but C2 pedicle fractures occurred in extreme flexion.
Area of Science:
- Orthopedic Surgery
- Biomechanical Engineering
- Spinal Instrumentation
Background:
- Occipitocervical fixation is crucial for stabilizing the upper spine.
- Traditional wiring techniques have limitations in providing adequate stability.
- Modern plate and screw systems aim to improve fixation outcomes.
Purpose of the Study:
- To biomechanically compare the stiffness and failure mechanisms of three occipitocervical instrumentation systems.
- To evaluate modern plate systems against traditional rod and wire constructs.
Main Methods:
- Human cadaveric occipitocervical specimens were used.
- Three instrumentation types were tested: AXIS Fixation System, Y-Plate, and Luque rectangle.
- Biomechanical testing involved compression, flexion, extension, and torsion loading modes.
Main Results:
- No significant stiffness differences were found under compression and flexion.
- Plate systems demonstrated statistically higher stiffness than the Luque rectangle in extension and torsion.
- Plate systems failed via C2 pedicle fracture in extreme flexion.
Conclusions:
- Modern plate systems provide superior stiffness and stability in extension and torsion compared to the Luque rectangle.
- Occipitocervical plate systems offer enhanced stability over traditional wiring.
- Surgeons can use this data to inform choices between modern plate/screw and traditional rod/wire constructs.