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Related Experiment Videos

C1-C2 Stabilization: Do Intrafacet Spacers Add any Stiffness to Traditional C1-C2 Fixation?

Forrest Hamrick1, Michael Karsy1,2, Evan Joyce1,3

  • 1Departments of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT.

Clinical Spine Surgery
|May 19, 2026
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

Articulations of the Vertebral Column01:28

Articulations of the Vertebral Column

In addition to being held together by the intervertebral discs, adjacent vertebrae also articulate with each other at synovial joints formed between the superior and inferior articular processes called zygapophysial joints (facet joints). These are plane joints that provide for only limited motions between the vertebrae. The orientation of the articular processes at these joints varies in different regions of the vertebral column and serves to determine the types of motions available in each...

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Cervical spine stabilization using intrafacet spacers (IFSs) with posterior instrumentation provides significant rigidity. IFSs alone are insufficient for stability, but enhance traditional constructs, offering equivalent stability to bone grafts.

Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering
  • Spinal fusion research

Background:

  • The C1-C2 junction is critical for cervical mobility, posing surgical stabilization challenges.
  • Traditional posterior instrumentation offers stability but has associated risks.
  • C1-C2 intrafacet spacers (IFSs) are explored as adjuncts for decompression and stabilization.

Purpose of the Study:

  • To evaluate the biomechanical contribution of C1-C2 intrafacet spacers (IFSs) to posterior instrumentation constructs.
  • To compare the stability provided by IFSs with traditional methods like bone grafting.

Main Methods:

  • A cadaveric study involving seven adult specimens.
  • 7-axis biomechanical testing to measure range of motion (ROM) at the O-C3 complex.
Keywords:
atlantoaxial junctionbiomechanical stabilitycervical spineintrafacet spacers

Related Experiment Videos

  • Sequential interventions included baseline, posterior instrumentation, bone graft, IFS, and combinations thereof.

    • Main Results:

    • Posterior instrumentation significantly reduced C1-C2 ROM in axial rotation, flexion-extension, and lateral bending (P<0.01).
    • IFSs alone did not provide stability and could increase ROM.
    • The stiffest construct combined traditional screw-rod instrumentation with a wired bone graft and IFS.

    Conclusions:

    • Traditional C1-C2 screw-rod constructs offer substantial biomechanical rigidity.
    • IFSs can augment construct stability but are not effective as standalone devices.
    • When added to C1-C2 screw-rod constructs, IFSs provide rigidity comparable to wired bone grafts.