Biomechanical Comparison of C1 Lateral Mass-C2 Short Pedicle Screw-C3 Lateral Mass Screw-Rod Construct Versus Goel-Harms Fixation for Atlantoaxial Instability

Spine
Young LuThay Q Lee

Abstract

A biomechanical in vitro study using human cadaveric spines. The aim of this study was to compare atlantoaxial stability and stiffness of a C1 lateral mass - C2 short pedicle - C3 lateral mass screw-rod construct versus C1 lateral mass - C2 pedicle screw-rod construct. The C1 lateral mass - C2 pedicle screw-rod construct provides excellent atlantoaxial fixation, but C2 pedicle screw placement is associated with risk of vertebral artery injury. The use of shorter C2 pedicle screws may mitigate the risk of vascular injury but may result in reduced C1-C2 stabilization. Extending C1 lateral mass - C2 short pedicle screw-rod construct with C3 lateral mass screws may mitigate the risk of vascular injury without compromising C1-C2 fixation. Seven cervical spines were tested with internal control experimental design in the following sequence: intact state, and following creation of type II odontoid fracture, the specimen was instrumented with C1 lateral mass - C2 pedicle screw fixation (C2PED), C1 lateral mass - C2 short pedicle screw fixation (C2SPED), and C1 lateral mass - C2 short pedicle - C3 lateral mass screw fixation (C2SPED-C3LM). For each condition, the angular stiffness and range of motion (ROM) with 1.5-Nm load in flexion/ex...Continue Reading

References

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Citations

Apr 25, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Heiko KollerClaudius Thome
Aug 8, 2021·International Journal of Environmental Research and Public Health·Torphong BunmaprasertPhichayut Phinyo

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