Faculty Collaboration Database

Posterior cervical spine crisscross fixation: Biomechanical evaluation. Clin Biomech (Bristol, Avon) 2018 Jun;55:18-22

Date

04/11/2018

Pubmed ID

29635141

DOI

10.1016/j.clinbiomech.2018.04.001

Scopus ID

2-s2.0-85045049079 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

BACKGROUND: Biomechanical/anatomic limitations may limit the successful implantation, maintenance, and risk acceptance of posterior cervical plate/rod fixation for one stage decompression-fusion. A method of posterior fixation (crisscross) that resolves biomechanical deficiencies of previous facet wiring techniques and not reliant upon screw implantation has been devised. The biomechanical performance of the new method of facet fixation was compared to the traditional lateral mass plate/screw fixation method.

METHODS: Thirteen human cadaver spine segments (C2-T1) were tested under flexion-compression loading and four were evaluated additionally under pure-moment load. Preparations were evaluated in a sequence of surgical alterations with intact, laminectomy, lateral mass plate/screw fixation, and crisscross facet fixation using forces, displacements and kinematics.

FINDINGS: Combined loading demonstrated significantly lower bending stiffness (p < 0.05) between laminectomy compared to crisscross and lateral mass plate/screw preparations. Crisscross fixation showed a comparative tendency for increased stiffness. The increased overall motion induced by laminectomy was resolved by both fixation techniques, with crisscross fixation demonstrating a comparatively more uniform change in segmental motions.

INTERPRETATION: The crisscross technique of facet fixation offers immediate mechanical stability with resolution of increased flexural rotations induced by multi-level laminectomy. Many of the anatomic limitations and potentially deleterious variables that may be associated with multi-level screw fixation are not associated with facet wire passage, and the subsequent fixation using a pattern of wire connection crossing each facet joint exhibits a comparatively more uniform load distribution. Crisscross wire fixation is a valuable addition to the surgical armamentarium for extensive posterior cervical single-stage decompression-fixation.

Author List

Cusick JF, Pintar FA, Cheng JS, Lifshutz JI, Yoganandan N

Authors

Frank A. Pintar PhD Chair, Professor in the Biomedical Engineering department at Medical College of Wisconsin
Narayan Yoganandan PhD Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Biomechanical Phenomena
Bone Plates
Bone Screws
Bone Wires
Cadaver
Cervical Vertebrae
Humans
Internal Fixators
Laminectomy
Middle Aged
Range of Motion, Articular
Spinal Fusion