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Related Experiment Videos

Posterior stabilization at the cervicothoracic junction: a biomechanical study.

Jennifer L Kreshak1, Daniel H Kim, Derek P Lindsey

  • 1Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut 06520-8071, USA.

Spine
|December 18, 2002
PubMed
Summary

Posterior fixation devices effectively stabilize two-column cervicothoracic spine injuries. However, these posterior systems are inadequate for three-column injuries, especially in extension, suggesting a need for supplemental anterior fixation.

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Area of Science:

  • Spine biomechanics
  • Orthopedic surgery
  • Spinal instrumentation

Background:

  • The cervicothoracic spine presents anatomical complexities, posing challenges for stabilizing traumatic and degenerative conditions.
  • Effective posterior stabilization of cervicothoracic junction injuries remains a critical clinical concern.

Purpose of the Study:

  • To biomechanically evaluate the stability of three posterior fixation devices for two- and three-column injuries of the cervicothoracic spine.
  • To determine the efficacy of posterior-only fixation for complex cervicothoracic spinal injuries.

Main Methods:

  • Biomechanical testing of 21 human cadaveric spines (C3-T3) under various loading conditions (flexion, extension, lateral bending, axial torsion).
  • Creation of sequential posterior two-column and three-column injuries at C7-T1.

Related Experiment Videos

  • Assessment of three posterior fixation systems (two rod-screw, one plate-screw) applied to C5, C6, T1, and T2 screws.

    • Main Results:

    • All posterior fixation systems provided adequate stability for two-column injuries across all tested motion planes.
    • Significant reduction in stiffness was observed in three-column injuries with posterior fixation compared to intact specimens, particularly in extension.
    • Posterior instrumentation reduced ranges of motion and neutral zones for two-column injuries but increased them for three-column injuries.

    Conclusions:

    • Posterior fixation alone is insufficient for stabilizing three-column cervicothoracic injuries, especially in extension.
    • Supplemental anterior fixation should be considered for three-column injuries at the cervicothoracic junction.
    • The evaluated posterior fixation systems offer viable stabilization for two-column injuries at this spinal level.