Posterior cervical fixation following laminectomy: a stress analysis of three techniques
- 12 February 2011
- journal article
- Published by Springer Science and Business Media LLC in European Spine Journal
- Vol. 20 (9), 1552-1559
- https://doi.org/10.1007/s00586-011-1711-z
Abstract
The aim of this study was to compare the following three main fixation techniques: pedicle screw (PS) technique, lateral mass screw (LS) technique, and transarticular screw (TS) technique. A detailed, geometrically accurate, nonlinear C3–C7 FE model had been successfully developed and validated. Then three finite element (FE) models were reconstructed by different fixation techniques following C4–C6 level laminectomy. A compressive preload of 74 N combined with a pure moment of 1.8 Nm in flexion, extension, left–right lateral bending, and left–right axial rotation was applied to the models. The results showed that maximum von Mises stress on the fixation devices was much higher in the FE models of TS technique, compared with the models of PS and LS techniques. Furthermore, the screws inserted by TS technique had high stress concentration at the middle part of the screws. Screw inserted by PS and LS techniques had high stress concentration at the actual cap–rod–screw interface. The highest level of maximal stress was obtained with the fixation device of the TS technique. TS technique induces noticeable differences in the stress compared to the posterior cervical fixation technique, regarding the higher stress level on fixation devices.Keywords
This publication has 30 references indexed in Scilit:
- Screw angulation affects bone-screw stresses and bone graft load sharing in anterior cervical corpectomy fusion with a rigid screw-plate construct: a finite element model studyThe Spine Journal, 2009
- Utility of modified transarticular screw in the middle and lower cervical spine as intermediate fixation in posterior long fusion surgeryJournal of Neurosurgery: Spine, 2009
- Local and global subaxial cervical spine biomechanics after single-level fusion or cervical arthroplastyEuropean Spine Journal, 2009
- Lateral radiological evaluation of transarticular screw placement in the lower cervical spineEuropean Spine Journal, 2009
- THE USE OF RIGID INTERNAL FIXATION IN THE SURGICAL MANAGEMENT OF CERVICAL SPONDYLOSISNeurosurgery, 2007
- Experimental flexion/extension data corridors for validation of finite element models of the young, normal cervical spineJournal of Biomechanics, 2006
- Sources of error in comparing functional magnetic resonance imaging and invasive electrophysiological recordingsJournal of Neurosurgery, 2000
- Uncinate processes and Luschka joints influence the biomechanics of the cervical spine: Quantification using a finite element model of the C5-C6 segmentJournal of Orthopaedic Research, 1997
- Load-displacement properties of lower cervical spine motion segmentsJournal of Biomechanics, 1988
- Spinal Deformity and Instability After Multilevel Cervical LaminectomySpine, 1987