Biomechanical analysis of new horizontal screw-screw crosslink in C1-C2 pedicle screw-rod fixation

doi:10.12307/2024.021

Abstract

Abstract: BACKGROUND: Posterior atlantoaxial pedicle screw rod internal fixation is the main method for treating atlantoaxial dislocation, and the horizontal crosslink plays an important role in the antirotation ability of the internal fixation system. The new horizontal screw-screw crosslink can effectively overcome the disadvantages of traditional horizontal crosslink, such as inconvenient installation, impact on bone grafting bed, and potential spinal cord injury. However, the biomechanical properties of the new horizontal screw-screw crosslink with different installation modes are still unclear.
OBJECTIVE: To investigate the biomechanical characteristics of new different installation modes of horizontal screw-screw crosslink in the C1-C2 pedicle screw-rod fixation and to provide a theoretical basis for optimal installation mode.
METHODS: Six fresh human occipitocervical specimens were divided into the intact state group (group A), and the atlantoaxial instability model of type II odontoid fracture was established based on the intact state group as the instability group (group B). The C1-C2 pedicle screw-rod fixation was performed on each specimen based on the instability group (group C). In group C, different installation modes of horizontal screw-screw crosslink were successively installed in each specimen, including upper transverse connection (two atlas screw tails) as group D, lower transverse connection (two axis screw tails) as group E, diagonal transverse connection (upper left and lower right for group F, lower left and upper right for group G), and cross transverse connection as group H. The specimen models were tested in order of flexion, extension, lateral flexion and lateral rotation on a three-dimensional motion machine, and the atlantoaxial range of motion of each group of specimens was obtained. Repeated measure analysis of variance was used to evaluate the biomechanical properties of each group.
RESULTS AND CONCLUSION: (1) Under six states, the range of motion of groups A, C, D, E, F, G and H was smaller than that of group B, and there were statistically significant differences (P < 0.05). (2) In the flexion and extension states, there was no significant difference among the five types of horizontal screw-screw crosslink groups (P > 0.05). (3) In the left and right rotation directions, there were significant differences in D and E groups compared with F, G and H groups (P < 0.05); there were no significant differences between D and E groups, and F and G groups (P > 0.05), and there were no significant differences in F and G groups compared with H group (P > 0.05). (4) In conclusion, under flexion-extension states, the biomechanical stability of five types of horizontal screw-screw crosslink groups was similar, but under the rotation state, the stability of diagonal horizontal screw-screw crosslink group and cross horizontal screw-screw crosslink group was obviously better than that of transverse horizontal screw-screw crosslink group; however, the stability of diagonal horizontal screw-screw crosslink group is similar to the cross horizontal screw-screw crosslink group, so the former is more worthy of clinical recommendation.

Key words: horizontal screw-screw crosslink, posterior, atlantoaxial, internal fixation, biomechanics

CLC Number:

Ouyang Beiping, Ma Xiangyang, Luo Chunshan, Zou Xiaobao, Lu Tingsheng, Chen Qiling. Biomechanical analysis of new horizontal screw-screw crosslink in C1-C2 pedicle screw-rod fixation[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(12): 1837-1841.

Figures/Tables 1

References

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