Biomechanical comparison of atlantoaxial crossed rod and parallel rod fixation technique for C2 unilateral lamina screws

doi:10.3969/j.issn.2095-4344.3777

Abstract

Abstract: BACKGROUND: The biomechanical stability of the screw-rod fixation system by C1 bilateral pedicle screws and C2 lamina screws was slightly insufficient. Posterior atlantoaxial fixation with screw-rod forms an approximate “II” shape or “H” increasing transverse-link for better stability. Crossed rod, constituted by connecting rods to the contralateral screws, forms an approximate “X” shape. This fixed construct just likes multi-triangles, whose stability is best, may further enhance the stability.
OBJECTIVE: To evaluate the three-dimensional biomechanical stability of the fixation technique for the crossed rod and parallel rod by the C1 bilateral pedicle screws combined with C2 one pedicle screw and the other lamina screw.
METHODS: Six fresh adult craniocervical specimens were used to test the biomechanical stability. All the specimens were fixed using C1 bilateral pedicle screws and C2 left pedicle screw and right lamina screw. The specimens were observed sequentially in three groups. The unstable group was not fixed. The parallel rod group was fixed by parallel rod connection. The crossed rod group was fixed by the crossed bar connection. The three-dimensional range of motion of the occipital axis was measured on a three-dimensional spinal motion testing machine.
RESULTS AND CONCLUSION: (1) The two internal fixation methods were better in the crossed rod and parallel rod groups than in the unstable group on flexion-extension, lateral bending and left and right axial rotation (P < 0.05). (2) The stability of the crossed rod group was equal to that of the parallel rod group on flexion-extension and lateral bending (P > 0.05). (3) The stability of the crossed rod group was better than that in the parallel rod group on left and right axial rotation (P < 0.05). (4) When the fixation with C1 bilateral pedicle screws and one C2 pedicle screw and the other lamina screw is used, crossed rod fixation can further enhance the axial rotation stability.

Key words: bone, atlantoaxial, atlantoaxial instability, internal fixation, crossed rod, parallel rod, biomechanics

CLC Number:

Qiu Feng, Xu Xilin, Ma Xiangyang, Fang Zhouqun, Jiang Weicheng, Tian Shuzhao, Zheng Zelong. Biomechanical comparison of atlantoaxial crossed rod and parallel rod fixation technique for C₂ unilateral lamina screws[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(12): 1805-1809.

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References

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Biomechanical comparison of atlantoaxial crossed rod and parallel rod fixation technique for C₂ unilateral lamina screws

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