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Biomechanical evaluation of cervical spinal stabilization methods in a human cadaveric model
J D Coe1, K E Warden, C E Sutterlin
1Department of Orthopaedic Surgery, Union Memorial Hospital, Baltimore, Maryland.
Spine
|October 1, 1989
Summary
Posterior cervical spine fixation methods showed no significant differences in stiffness. Caspar anterior plating was inferior for distractive-flexion injuries compared to posterior techniques.
Area of Science:
- Orthopedics
- Biomechanical Engineering
- Spine Surgery
Background:
- Previous in vitro biomechanical testing of posterior and anterior cervical constructs was performed in a bovine model.
- Human cadaveric spines are used to evaluate various posterior and anterior stabilization techniques for cervical spine injuries.
Purpose of the Study:
- To biomechanically evaluate the efficacy of eight different posterior and anterior spinal constructs in human cadaveric cervical spine specimens with simulated Stage 3 distractive-flexion injuries.
- To compare the biomechanical performance of Caspar anterior plating against posterior fixation methods for cervical spine stabilization.
Main Methods:
- Six subaxial human cervical spine specimens were subjected to simulated Stage 3 distractive-flexion injuries at the C5-C6 motion segment.
- Cyclic loads simulating cervical compression, flexion, extension, and rotation were applied using a materials tester.
- Measurements included axial load, displacement, torque, rotation, and anterior/posterior strains for intact and instrumented segments.
Main Results:
- No significant differences in flexural or torsional stiffness were found between any of the tested constructs.
- Caspar anterior plate fixation showed a significant increase in posterior strain during flexion and axial loading compared to all other constructs.
- Posterior stabilization methods, including sublaminar wiring, Rogers' wiring, Bohlman's wiring, and plate fixations, demonstrated comparable stiffness.
Conclusions:
- Posterior cervical fixation techniques provide comparable biomechanical stability for distractive-flexion injuries.
- Caspar anterior plating is biomechanically inferior to posterior fixation methods for treating these specific cervical spine injuries.
- Interspinous wiring techniques (Rogers' and Bohlman) offer comparable rigidity to more invasive posterior methods, suggesting a safer alternative.