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Posterior cervical spine crisscross fixation: Biomechanical evaluation
Joseph F Cusick1, Frank A Pintar2, Joseph S Cheng3
1Department of Neurosurgery, Medical College of Wisconsin and Veterans Affairs Medical Center, Milwaukee, WI, United States.
Clinical Biomechanics (Bristol, Avon)
|April 11, 2018
Summary
A novel crisscross facet fixation technique offers improved biomechanical stability for posterior cervical decompression and fusion compared to traditional methods. This technique resolves instability from laminectomy without screw reliance, enhancing surgical options.
Area of Science:
- Spine biomechanics
- Orthopedic surgery
- Biomaterials and implants
Background:
- Posterior cervical fixation methods face limitations in stability and risk for single-stage decompression-fusion.
- Existing facet wiring techniques have biomechanical deficiencies.
- A novel crisscross posterior fixation method, independent of screw implantation, has been developed.
Purpose of the Study:
- To compare the biomechanical performance of the new crisscross facet fixation technique against traditional lateral mass plate/screw fixation.
- To evaluate the efficacy of crisscross fixation in resolving biomechanical deficiencies in posterior cervical fixation.
Main Methods:
- Testing of thirteen human cadaver spine segments (C2-T1) under flexion-compression and pure-moment loading.
- Evaluation of biomechanical parameters (forces, displacements, kinematics) through sequential surgical alterations: intact, laminectomy, lateral mass plate/screw fixation, and crisscross facet fixation.
Main Results:
- Laminectomy significantly reduced bending stiffness compared to both crisscross and lateral mass plate/screw preparations (p<0.05).
- Crisscross fixation demonstrated a tendency towards increased stiffness and resolved laminectomy-induced motion more uniformly than lateral mass fixation.
Conclusions:
- The crisscross facet fixation technique provides immediate mechanical stability and resolves increased flexural rotations following multi-level laminectomy.
- This method avoids anatomic limitations and risks associated with multi-level screw fixation.
- Crisscross wire fixation is a valuable alternative for extensive posterior cervical single-stage decompression-fixation.
Keywords:
Crisscross facet wiringLateral mass plate/screwsPosterior cervical internal fixationSegmental motionMore Related Videos
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