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A biomechanical comparison of three different posterior fixation constructs used for C6-C7 cervical spine immobilization: a finite element study

A biomechanical comparison of three different posterior fixation constructs used for C6-C7 cervical spine immobilization: a finite element study
A biomechanical comparison of three different posterior fixation constructs used for C6-C7 cervical spine immobilization: a finite element study
The intralaminar screw construct has been recently introduced in C6-C7 fixation. The aim of the study is to compare the stability afforded by three different C7 posterior fixation techniques using a three-dimensional finite element model of a C6-C7 cervical spine motion segment. Finite element models representing three different cervical anchor types (C7 intralaminar screw, C7 lateral mass screw, and C7 pedicle screw) were developed. Range of motion (ROM) and maximum von Mises stresses in the vertebra for the three screw techniques were compared under pure moments in flexion, extension, lateral bending, and axial rotation. ROM for pedicle screw construct was less than the lateral mass screw construct and intralaminar screw construct in the three principal directions. The maximum von Misses stress was observed in the C7 vertebra around the pedicle in all the three screw constructs. Maximum von Mises stress in pedicle screw construct was less than the lateral mass screw construct and intralaminar screw construct in all loading modes. This study demonstrated that the pedicle screw fixation is the strongest instrumentation method for C6-C7 fixation. Pedicle screw fixation resulted in least stresses around the C7 pedicle-vertebral body complex. However, if pedicle fixation is not favorable, the laminar screw can be a better option compared to the lateral mass screw because the stress around the pedicle-vertebral body complex and ROM predicted for laminar screw construct was smaller than those of lateral mass screw construct.
Biomechanical Phenomena, Cervical Vertebrae/surgery, Computer Simulation, Finite Element Analysis, Humans, Pedicle Screws, Spinal Fusion/instrumentation, Weight-Bearing/physiology
0470-8105
727-735
Hong, Jae Taek
1cf35804-00f2-4084-b3f4-aeac8e83677a
Qasim, Muhammad
2952cbef-3a52-4fe2-a1a2-c58876c22f91
Espinoza Orías, Alejandro A
9b84945a-af1f-44bf-83b6-6b502ec79c34
Natarajan, Raghu N
bdc5a3f0-1c7a-44b3-b576-4868674b28dc
An, Howard S
abe2b9c6-dec5-428f-8bdc-52fdf5047c7f
Hong, Jae Taek
1cf35804-00f2-4084-b3f4-aeac8e83677a
Qasim, Muhammad
2952cbef-3a52-4fe2-a1a2-c58876c22f91
Espinoza Orías, Alejandro A
9b84945a-af1f-44bf-83b6-6b502ec79c34
Natarajan, Raghu N
bdc5a3f0-1c7a-44b3-b576-4868674b28dc
An, Howard S
abe2b9c6-dec5-428f-8bdc-52fdf5047c7f

Hong, Jae Taek, Qasim, Muhammad, Espinoza Orías, Alejandro A, Natarajan, Raghu N and An, Howard S (2014) A biomechanical comparison of three different posterior fixation constructs used for C6-C7 cervical spine immobilization: a finite element study. Neurologia medico-chirurgica, 54 (9), 727-735. (doi:10.2176/nmc.oa.2013-0004).

Record type: Article

Abstract

The intralaminar screw construct has been recently introduced in C6-C7 fixation. The aim of the study is to compare the stability afforded by three different C7 posterior fixation techniques using a three-dimensional finite element model of a C6-C7 cervical spine motion segment. Finite element models representing three different cervical anchor types (C7 intralaminar screw, C7 lateral mass screw, and C7 pedicle screw) were developed. Range of motion (ROM) and maximum von Mises stresses in the vertebra for the three screw techniques were compared under pure moments in flexion, extension, lateral bending, and axial rotation. ROM for pedicle screw construct was less than the lateral mass screw construct and intralaminar screw construct in the three principal directions. The maximum von Misses stress was observed in the C7 vertebra around the pedicle in all the three screw constructs. Maximum von Mises stress in pedicle screw construct was less than the lateral mass screw construct and intralaminar screw construct in all loading modes. This study demonstrated that the pedicle screw fixation is the strongest instrumentation method for C6-C7 fixation. Pedicle screw fixation resulted in least stresses around the C7 pedicle-vertebral body complex. However, if pedicle fixation is not favorable, the laminar screw can be a better option compared to the lateral mass screw because the stress around the pedicle-vertebral body complex and ROM predicted for laminar screw construct was smaller than those of lateral mass screw construct.

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More information

Published date: 1 February 2014
Keywords: Biomechanical Phenomena, Cervical Vertebrae/surgery, Computer Simulation, Finite Element Analysis, Humans, Pedicle Screws, Spinal Fusion/instrumentation, Weight-Bearing/physiology

Identifiers

Local EPrints ID: 446662
URI: http://eprints.soton.ac.uk/id/eprint/446662
ISSN: 0470-8105
PURE UUID: 7114fbae-609e-466c-97bc-c0ed7dc932a7

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Date deposited: 17 Feb 2021 17:31
Last modified: 16 Mar 2024 10:48

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Contributors

Author: Jae Taek Hong
Author: Muhammad Qasim
Author: Alejandro A Espinoza Orías
Author: Raghu N Natarajan
Author: Howard S An

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