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Cervical spine loading characteristics in a cadaveric C5 corpectomy model using a static and dynamic plate.
D Reidy1, J Finkelstein, A Nagpurkar
1Orthopaedic Biomechanics Laboratory, Division of Orthopaedics, Sunnybrook and Women's College Health Sciences Center, Toronto, Ontario, Canada.
Journal of Spinal Disorders & Techniques
|July 21, 2004
Summary
Dynamic cervical plates enhance graft load transmission in anterior cervical fusion, especially with smaller grafts. Posterior elements also significantly influence load distribution, impacting fusion success.
Area of Science:
- Spine Surgery
- Biomechanics
- Orthopedic Research
Background:
- Anterior cervical plates stabilize fusions but may cause graft stress shielding, potentially lowering fusion rates.
- Understanding load transmission is crucial for optimizing anterior cervical fusion outcomes.
Purpose of the Study:
- To quantify the impact of graft size and plating type (static vs. dynamic) on load transmission.
- To evaluate the role of posterior elements in load distribution during anterior cervical fusion.
Main Methods:
- Human cervical spine specimens (C3-C7) underwent C5 corpectomy.
- Axial compressive testing was performed using instrumented grafts and dynamic plates.
- Testing included static vs. dynamic plating, optimal vs. undersized grafts, and intact vs. removed posterior elements.
Main Results:
- Dynamic plating significantly increased graft load transmission, particularly with undersized grafts.
- The presence of posterior elements substantially influenced axial load transmission.
Conclusions:
- Dynamic plating may mitigate stress shielding by improving graft load transmission.
- Posterior elements are critical contributors to load-bearing in the cervical spine during fusion.