Cervical end of an occipitocervical fusion: a biomechanical evaluation of 3 constructs

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Publication Type Journal Article
School or College School of Medicine
Department Neurosurgery
Creator Dailey, Andrew T.; Brodke, Darrel S.
Other Author Finn, Michael A.; Fassett, Daniel R.; Mccall, Todd D.; Clark, Randy
Title Cervical end of an occipitocervical fusion: a biomechanical evaluation of 3 constructs
Date 2008
Description Object. Stabilization with rigid screw/rod fixation is the treatment of choice for craniocervical disorders requiring operative stabilization. The authors compare the relative immediate stiffness for occipital plate fixation in concordance with transarticular screw fixation (TASF), C-1 lateral mass and C-2 pars screw (C1L-C2P), and C-1 lateral mass and C-2 laminar screw (C1L-C2L) constructs, with and without a cross-link. Methods. Ten intact human cadaveric spines (Oc-C4) were prepared and mounted in a 7-axis spine simulator. Each specimen was precycled and then tested in the intact state for flexion/extension, lateral bending, and axial rotation. Motion was tracked using the OptoTRAK 3D tracking system. The specimens were then destabilized and instrumented with an occipital plate and TASF. The spine was tested with and without the addition of a cross-link. The C1L-C2P and C1L-C2L constructs were similarly tested. Results. All constructs demonstrated a significant increase in stiffness after instrumentation. The C1L-C2P construct was equivalent to the TASF in all moments. The C1L-C2L was significantly weaker than the C1L-C2P construct in all moments and significantly weaker than the TASF in lateral bending. The addition of a cross-link made no difference in the stiffness of any construct. Conclusions. All constructs provide significant immediate stability in the destabilized occipitocervical junction. Although the C1L-C2P construct performed best overall, the TASF was similar, and either one can be recommended. Decreased stiffness of the C1L-C2L construct might affect the success of clinical fusion. This construct should be reserved for cases in which anatomy precludes the use of the other two.
Type Text
Publisher American Association of Neurological Surgeons (AANS)
Volume 9
Issue 3
First Page 296
Last Page 300
Subject Harms technique; Occipitocervical fusion; Transarticular screw; Translaminar screw; Craniocervical instability
Subject LCSH Cervical vertebrae -- Surgery; Bone screws (Orthopedics)
Language eng
Bibliographic Citation Finn, M. A., Fassett, D. R., Mccall, T. D., Clark, R., Dailey, A. T., & Brodke, D. S. (2008). Cervical end of an occipitocervical fusion: a biomechanical evaluation of 3 constructs. Laboratory investigation. Journal of Neurosurgery Spine, 9(3), 296-300.
Rights Management (c) American Association of Neurological Surgeons
Format Medium application/pdf
Format Extent 1,118,925 bytes
Identifier ir-main,13267
ARK ark:/87278/s6tm7v6v
Setname ir_uspace
Date Created 2012-06-13
Date Modified 2012-06-13
ID 702384
Reference URL https://collections.lib.utah.edu/ark:/87278/s6tm7v6v