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Cervical spine locking plate: in vitro biomechanical testing.

S A Smith¹, R W Lindsey, B J Doherty

¹Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX 77030, USA.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

|January 9, 2010

Summary

The AO cervical spine locking plate (CSLP) restored flexion stability in cadaver models but failed to fully restore rotational stability. Further fixation may be needed for complete torsional stability.

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Area of Science:

Orthopedic Surgery
Biomechanical Engineering
Spinal Fusion Devices

Background:

The AO cervical spine locking plate (CSLP) is increasingly used for anterior subaxial fixation.
Limited in vitro data exists on the mechanical properties of the CSLP.

Purpose of the Study:

To evaluate the in vitro biomechanical properties of the CSLP in human cadaver cervical spines.
To assess the CSLP's ability to restore stability after destabilization.

Main Methods:

Five fresh human cadaver cervical spines underwent non-destructive testing in flexion and torsion.
Testing included intact spine, destabilized spine, and destabilized spine with CSLP.
Large angular displacement tests assessed fixation integrity in the CSLP group.

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Main Results:

CSLP reduced mean spinous process displacement in flexion from 3.19 mm (destabilized) to 1.37 mm.
Torsional stiffness increased with CSLP (2.20 Nm/degree) compared to destabilized (1.82 Nm/degree) but remained below intact (2.86 Nm/degree).
Screw loosening occurred in 2/5 specimens during large angular displacement testing; no plate loosening was observed.

Conclusions:

The CSLP effectively restores flexion stability in a severely destabilized in vitro cervical spine model.
The CSLP does not fully restore rotational stability, indicating a need for supplemental fixation.
Further research into combined fixation strategies may be necessary for optimal torsional stability restoration.