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Biomechanical compa...
Biomechanical comparison of five different atlantoaxial posterior fixation techhniques
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- Henriques, Thomas (författare)
- Uppsala universitet,Ortopedi
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Cunningham, Bryan (författare)
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- Olerud, Claes (författare)
- Uppsala universitet,Ortopedi
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Shimamoto, Norimichi (författare)
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Lee, Guy (författare)
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- Larsson, Sune (författare)
- Uppsala universitet,Ortopedi
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McAfee, Paul (författare)
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visa färre...
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(creator_code:org_t)
- 2000
- 2000
- Engelska.
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Ingår i: Spine. - 0362-2436 .- 1528-1159. ; 25:22, s. 2877-2883
- Relaterad länk:
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https://urn.kb.se/re...
Abstract
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- STUDY DESIGN:Five different reconstructions of the atlantoaxial complex were biomechanically compared in vitro in a nondestructive test.OBJECTIVES:To determine whether non-bone graft-dependent one-point fixation affords stability levels equivalent to three-point reconstructions.SUMMARY OF BACKGROUND DATA:Previous investigations have demonstrated that three-point fixation, using bilateral transarticular screws in combination with posterior wiring, provide the most effective resistance to minimize motion around C1-C2. However, placement of transarticular screws is technically demanding. Posterior wiring techniques affording one-point fixation have failure rates of approximately 15%, with failure considered to be secondary to structural bone graft failures. One-point, non-bone graft-dependent fixations have not been tested.METHODS:Eight human cervical specimens, C0-C3 were loaded nondestructively. Unconstrained three-dimensional segmental motion was measured. The reconstructions tested were two one-point fixations, one two-point fixation, and two three-point fixations.RESULTS:Under axial rotation two and three-point reconstructions provided better stiffness than the one-point reconstructions (P < 0.05). During flexion-extension, higher stiffness levels were observed in one- and three-point fixations when compared with the intact spine (P < 0.05). In lateral bending no significant differences were observed among the six groups, although the trend was that reconstructions including transarticular screws provided greater stability than one-point fixations.CONCLUSION:The current findings substantiate the use of three-point fixation as the treatment of choice for C1-C2 instability. [l: atlantoaxial fixation, biomechanics, cervical spine, instability, spinal instrumentation, transarticular screws]
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