Evidence map›Paper›PMID 38811940›Full record

ArticleBMC musculoskeletal disorders2024

The C2 isthmus screw provided sufficient biomechanical stability in the setting of atlantoaxial dislocation-a finite element study.

Minming Lu, Zhenqiang Wang, Bo Yuan, Yifan Tang, Changjiang Gu, Shengyuan Zhou, Xiongsheng Chen

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Article in BMC musculoskeletal disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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3 citing papers in PubMed.

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5 · Who and what money

Authors and funding

7 authors.

Minming Lu *Spine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University, (Second Military Medical University), Shanghai, 200003, P.R. China.
Zhenqiang Wang *Spine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University, (Second Military Medical University), Shanghai, 200003, P.R. China.
Bo YuanSpine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University, (Second Military Medical University), Shanghai, 200003, P.R. China.
Yifan TangSpine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University, (Second Military Medical University), Shanghai, 200003, P.R. China.
Changjiang GuSpine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University, (Second Military Medical University), Shanghai, 200003, P.R. China.
Shengyuan ZhouSpine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University, (Second Military Medical University), Shanghai, 200003, P.R. China.
Xiongsheng ChenSpine Center, Department of Orthopaedics, Changzheng Hospital Naval Medical University, (Second Military Medical University), Shanghai, 200003, P.R. China. cxspine@smmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe emerging of the C2 isthmus screw fixation technique is gaining popularity in the setting of atlantoaxial dislocation or other conditions requiring fixation of C2. However, the biomechanical stability of this fixation is poorly understood. PURPOSE: To compare and elucidate the biomechanical stability of C2 pedicle screw (C2PS), C2 isthmus screw (C2IS) and C2 short isthmus screw (C2SIS) fixation techniques in atlantoaxial dislocation (AAD).

methodA three-dimensional finite element model (FEM) from occiput to C3 was established and validated from a healthy male volunteer. Three FEMs, C1 pedicle screw (PS)-C2PS, C1PS-C2IS, C1PS-C2SIS were also constructed. The range of motion (ROM) and the maximum von Mises stress under flexion, extension, lateral bending and axial rotation loading were analyzed and compared. The pullout strength of the three fixations for C2 was also evaluated.

resultC1PS-C2IS model showed the greatest decrease in ROM with flexion, extension, lateral bending and axial rotation. C1PS-C2PS model showed the least ROM reduction under all loading conditions than both C2IS and C2SIS. The C1PS-C2PS model had the largest von Mises stress on the screw under all directions followed by C1PS-C2SIS, and lastly the C1PS-C2IS. Under axial rotation and lateral bending loading, the three models showed the maximum and minimum von Mises stress on the screw respectively. The stress of the three models was mainly located in the connection of the screw and rod. Overall, the maximum screw pullout strength for C2PS, C2IS and C2SIS were 729.41N, 816.62N, 640.54N respectively.

conclusionIn patients with atlantoaxial dislocations, the C2IS fixation provided comparable stability, with no significant stress concentration. Furthermore, the C2IS had sufficient pullout strength when compared with C2PS and C2SIS. C2 isthmus screw fixation may be a biomechanically favourable option in cases with AAD. However, future clinical trials are necessary for the evaluation of the clinical outcomes of this technique.

Indexed as

Atlanto-Axial JointFinite Element AnalysisJoint DislocationsRange of Motion, ArticularAdultBiomechanical PhenomenaBone ScrewsHumansMalePedicle ScrewsSpinal FusionAtlantoaxial dislocationsBiomechanicsFinite element modelIsthmus screwPosterior fixation

Identifiers

PMID38811940
PMCPMC11138020

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.