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[Biomechanical study on effect of polymethylmethacrylate augmentation on cervical stability after anterior cervical
Chun Chen1, Weidong Zhao, Peidong Sun
1Department of Human Anatomy, Southern Medical University, Guangdong Provincial Key Laboratory of Medical Biomechanics, Guangzhou Guangdong 510515, PR China.
Objective:
To evaluate the effect of polymethylmethacrylate (PMMA) augmentation on cervical stability after anterior cervical interbody fusion (ACIF) before and after fatigue.
Methods:
Twelve porcine cervical spines (C3-7) were subjected to testing angular displacement parameters, including the range of motion (ROM), neutral zone (NZ), and elastic zone (EZ), in nondestructive flexion and extension, right/left lateral bending, and left/right rotation on Motion Analysis motion capture system and MTS-858 servo-hydraulic testing machine. Intact cervical spines served as control group (group A); one-level discectomy and fusion was performed with anterior plate fixation based on group A as group B; flexion and extension, left/right lateral bending (5 000 cycles) fatigue testing based on group B as group C; the augmentation screw channel was used based on group C as group D; and flexion and extension, left/right lateral bending fatigue testing were performed based on group D as group E.
Results:
The ROM, NZ, and EZ in group A were significantly different from those in other groups (P < 0.05) at flexion/extension, left/right bending, and left/right rotation. The ROM, NZ, and EZ in group B were significantly smaller than those in group C (P < 0.05) in flexion/extension, left/right bending, and left/right rotation, but there was no significant difference when compared with group D (P > 0.05). The ROM and NZ in flexion/extension and the EZ in flexion in group B were significant smaller than those in group E (P < 0.05), but there was no significant difference in the other indexes (P > 0.05). The ROM, NZ, and EZ in group C in flexion and extension, left/right lateral bending, and left/right rotation were significantly higher than those in groups D and E (P < 0.05). The ROM and NZ in flexion and extension and left/right lateral bending, and the ROM in left/right rotation, and the EZ in flexion and extension, right bending, and left/right rotation in group D were significantly smaller than those in group E (P < 0.05), but there was no significant difference in the other indexes (P > 0.05).
Conclusion:
PMMA augmentation can significantly increase the instant cervical stability and provide a biomechanics basis in cervical anterior plate fixation.