ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2017
Cement-augmented screws in a cervical two-level corpectomy with anterior titanium mesh cage reconstruction: a biomechanical study.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Pars interarticularis screws for posterior cervical fusion - investigating a new trajectory using a CT-based multiplanar reconstruction: Part I.Acta neurochirurgica · 2024Article
- A Review of Strategies to Improve Biomechanical Fixation in the Cervical Spine.Global spine journal · 2022Article
- Anterior 1-2 Level Cervical Corpectomy and Fusion for Degenerative Cervical Disease: A Retrospective Study With Lordotic Porous Tantalum Cages. Long-Term Changes in Sagittal Alignment and Their Clinical and Radiological Implications After Cage Subsidence.International journal of spine surgery · 2022Article
- Investigation into Cervical Spine Biomechanics Following Single, Multilevel and Hybrid Disc Replacement Surgery with Dynamic Cervical Implant and Fusion: A Finite Element Study.Bioengineering (Basel, Switzerland) · 2022Article
- Surgical nuances and construct patterns influence construct stiffness in C1-2 stabilizations: a biomechanical study of C1-2 gapping and advanced C1-2 fixation.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Article
- Article
- Progress of the Anterior Transpedicular Screw in Lower Cervical Spine: A Review.Medical science monitor : international medical journal of experimental and clinical research · 2019Review
- Retrospective analysis of cervical corpectomies: implant-related complications of one- and two-level corpectomies in 45 patients.Neurosurgical review · 2018Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designBiomechanical investigation. PURPOSE: Cervical two-level corpectomies with anterior-only instrumentation are associated with a high rate of implant-related complications. These procedures, therefore, often require an additional dorsal instrumentation to prevent screw loosening. Cement augmentation of the anterior screws in two-level corpectomies might stabilize the construct, so that a second dorsal procedure could be avoided. To evaluate the screw anchorage in cervical anterior-only procedures, an ex vivo evaluation of the range of motion (ROM) in two-level corpectomies (C4 and C5), with and without cement augmentation of the anterior screws, was carried out in this study.
methodsTwelve human cervical cadaveric spines (C2-T1) were divided into two groups of six specimens each. Corpectomies were performed in C4 and C5, with grafting and anterior instrumentation with and without cement augmentation of the anterior screw-and-plate system (0.3-0.5 mL cement/screw). Flexibility tests with pure moments (1.5 Nm) were carried out before and after three cyclic loading periods of 5000 cycles with increasing eccentric forces (100, 200, and 300 N).
resultsAfter corpectomy and instrumentation, the control group and the augmented group showed a significant reduction in ROM in comparison with the native states with average ROMs of 49% (±17%) and 24% (±10%), respectively (P = 0.006). The ROM in the control group increased significantly in all motion directions in the course of cyclic loading and approached native values after the third cyclic loading period, with an overall ROM of 78% (±22%). In contrast, the augmented group maintained a significantly decreased ROM in all motion directions during cyclic loading, with a final ROM of 32% (±14%) after the third period of cyclic testing. Inter-group comparison demonstrated a significant difference between the two groups in the course of cyclic loading. The cement-augmented group outperformed the control group in all motion directions, with a significantly lower ROM after all three cyclic loading periods.
conclusionsA two-level corpectomy with cement-augmentation results in a significantly reduced ROM. In comparison with the conventional anterior screw-and-plate fixation, it represents a significantly stabilized two-level anterior construct. This might be a treatment option for patients with a two-level corpectomy associated with reduced bone mineral density, to avoid an additional dorsal instrumentation.
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