Biomechanical Evaluation of Four Different Posterior Atlantoaxial Fixation Techniques

Study Design: Biomechanical, cadaveric study. Objectives: To compare the relative stiffness of unilateral C1 lateral mass-C2 intralaminar fixation to intact specimens and bilateral C1 lateral mass-C2 intralaminar constructs. Methods: The biomechanical integrity of a unilateral C1 lateral mass-C2 intralaminar screw construct was compared to intact specimens and bilateral C1 lateral mass-C2 intralaminar screw constructs. Five human cadaveric specimens were used. Range of motion and stiffness were tested to determine the stiffness of the constructs. Results: Unilateral fixation significantly decreased flexion/extension range of motion compared to intact ( P < .001) but did not significantly affect axial rotation ( P = .3) or bending range of motion ( P = .3). There was a significant decrease in stiffness in extension for both unilateral and bilateral fixation techniques compared to intact ( P = .04 and P = .03, respectively). There was also a significant decrease in stiffness for ipsilateral rotation for the unilateral construct compared to intact ( P = .007) whereas the bilateral construct significantly increased ipsilateral rotation stiffness compared to both intact and unilateral fixation ( P < .001). Conclusion: Bilateral constructs did show improved biomechanical properties compared to the unilateral constructs. However, unilateral C1-C2 fixation using a C1 lateral mass and C2 intralaminar screw-rod construct decreased range of motion and improved stiffness compared to the intact state with the exception of extension and ipsilateral rotation. Hence, a unilateral construct may be acceptable in clinical situations in which bilateral fixation is not possible, but an external orthosis may be necessary to achieve a fusion.

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A biomechanical evaluation of bone stability with different types of rigid internal fixation techniques for subcondylar fractures

Japanese Journal of Oral & Maxillofacial Surgery ◽

10.5794/jjoms.50.515 ◽

2004 ◽

Vol 50 (9) ◽

pp. 515-521

Author(s):

Yasuhiro MIMORI ◽

Kazuhiro TOMINAGA ◽

Amit KHANAL ◽

Manabu HABU ◽

Soichi HIRASHIMA ◽

...

Keyword(s):

Internal Fixation ◽

Rigid Internal Fixation ◽

Different Types ◽

Fixation Techniques ◽

Biomechanical Evaluation

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Salvage posterior atlantoaxial fixation techniques: A retrospective study

Neurocirugía ◽

10.1016/j.neucir.2021.08.002 ◽

2021 ◽

Author(s):

Mehmet Seçer ◽

Oğuz Durmuş Karakoyun ◽

Murat Ulutaş ◽

Aykut Gökbel ◽

Kadir Çınar ◽

...

Keyword(s):

Retrospective Study ◽

Fixation Techniques ◽

Atlantoaxial Fixation

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Biomechanical evaluation of mandibular fixation techniques in patients with obstructive sleep apnea: a human cadaveric study

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2020.08.044 ◽

2021 ◽

Vol 131 (1) ◽

pp. e36-e37

Author(s):

FALEH ALSHAHRANI ◽

WICHUDA KONGSONG ◽

SITTI SITTITAVORNWONG

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Cadaveric Study ◽

Obstructive Sleep ◽

Fixation Techniques ◽

Biomechanical Evaluation

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Atlantoaxial stabilization using multiaxial C-1 posterior arch screws

Journal of Neurosurgery Spine ◽

10.3171/spi.2008.10.08294 ◽

2008 ◽

Vol 9 (6) ◽

pp. 522-527 ◽

Cited By ~ 10

Author(s):

Michael B. Donnellan ◽

Ioannis G. Sergides ◽

William R. Sears

Keyword(s):

Clinical Results ◽

Posterior Arch ◽

Lateral Mass ◽

Normal Anatomy ◽

Novel Technique ◽

Vertebral Arteries ◽

Fixation Techniques ◽

Atlantoaxial Fixation ◽

Atlantoaxial Stabilization ◽

Lateral Mass Screws

The authors present a novel technique of atlantoaxial fixation using multiaxial C-1 posterior arch screws. The technique involves the insertion of bilateral multiaxial C-1 posterior arch screws, which are connected by crosslinked rods to bilateral multiaxial C-2 pars screws. The clinical results are presented in 3 patients in whom anomalies of the vertebral arteries, C-1 lateral masses, and/or posterior arch of C-1 presented difficulty using existing fixation techniques with transarticular screws, C-1 lateral mass screws, or posterior wiring. The C-1 posterior arch screws achieved solid fixation and their insertion appeared to be technically less demanding than that of transarticular or C-1 lateral mass screws. This technique may reduce the risk of complications compared with existing techniques, especially in patients with anatomical variants of the vertebral artery, C-1 lateral masses, or C-1 posterior arch. This technique may prove to be an attractive fixation option in patients with normal anatomy.

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