ArticleBMC musculoskeletal disorders2015
Biomechanical comparison of a novel transoral atlantoaxial anchored cage with established fixation technique - a finite element analysis.
Article in BMC musculoskeletal disorders, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 35 citations in OpenAlex.
- Biomechanical assessment of endoscopic cross-over top decompression in cervical spinal stenosis: a finite element analysis.BMC musculoskeletal disorders · 2026Article
- Biomechanical evaluation of In-Out-In pedicle screws for atlantoaxial posterior fixation in the presence of high-riding vertebral artery and narrow C2 pedicles: a finite element analysis.Journal of orthopaedic surgery and research · 2025Article
- A novel Z-shaped anti-rotation rod for atlantoaxial dislocation reduction: finite element analysis.Journal of orthopaedic surgery and research · 2025Article
- The range of motion characteristics of atlantoaxial joints with the "sandwich" deformity: a human cadaveric biomechanical study.Neurosurgical review · 2025Article
- The C2 isthmus screw provided sufficient biomechanical stability in the setting of atlantoaxial dislocation-a finite element study.BMC musculoskeletal disorders · 2024Article
- Clinical Outcomes and Cost Profiles for Cage and Allograft Anterior Cervical Discectomy and Fusion Procedures in the Adult Population: A Propensity Score-Matched Study.Asian spine journal · 2023Article
- Biomechanical evaluation of a novel integrated artificial axis: A finite element study.Medicine · 2017Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe transoral atlantoaxial reduction plate (TARP) fixation has been introduced to achieve reduction, decompression, fixation and fusion of C1-C2 through a transoral-only approach. However, it may also be associated with potential disadvantages, including dysphagia and load shielding of the bone graft. To prevent potential disadvantages related to TARP fixation, a novel transoral atlantoaxial fusion cage with integrated plate (Cage + Plate) device for stabilization of the C1-C2 segment is designed. The aims of the present study were to compare the biomechanical differences between Cage + Plate device and Cage + TARP device for the treatment of basilar invagination (BI) with irreducible atlantoaxial dislocation (IAAD).
methodsA detailed, nonlinear finite element model (FEM) of the intact upper cervical spine had been developed and validated. Then a FEM of an unstable BI model treated with Cage + Plate fixation, was compared to that with Cage + TARP fixation. All models were subjected to vertical load with pure moments in flexion, extension, lateral bending and axial rotation. Range of motion (ROM) of C1-C2 segment and maximum von Mises Stress of the C2 endplate and bone graft were quantified for the two devices.
resultsBoth devices significantly reduced ROM compared with the intact state. In comparison with the Cage + Plate model, the Cage + TARP model reduced the ROM by 82.5 %, 46.2 %, 10.0 % and 74.3 % in flexion, extension, lateral bending, and axial rotation. The Cage + Plate model showed a higher increase stresses on C2 endplate and bone graft than the Cage + TARP model in all motions.
conclusionsOur results indicate that the novel Cage + Plate device may provide lower biomechanical stability than the Cage + TARP device in flexion, extension, and axial rotation, however, it may reduce stress shielding of the bone graft for successful fusion and minimize the risk of postoperative dysphagia. Clinical trials are now required to validate the reproducibility and advantages of our findings using this anchored cage for the treatment of BI with IAAD.
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