Anatomical, biomechanical, and practical considerations in posterior occipitocervical instrumentation. Spine J 2006;6(6 Suppl):225S-232S
Date
11/14/2006Pubmed ID
17097542DOI
10.1016/j.spinee.2006.09.001Scopus ID
2-s2.0-33750621452 (requires institutional sign-in at Scopus site) 47 CitationsAbstract
BACKGROUND CONTEXT: Patients with cervical myelopathy secondary to craniocervical instability commonly present with spinal cord compression secondary to a combination of static forces and gross instability. Craniocervical arthrodesis is therefore indicated in the treatment of the majority of these conditions. In order to facilitate arthrodesis, techniques for occipitocervical instrumentation have been developed.
PURPOSE: To systematically review the anatomy, biomechanics, and practical considerations involved in posterior occipitocervical instrumentation.
STUDY DESIGN: Retrospective literature review.
PATIENT SAMPLE: Not applicable.
OUTCOME MEASURES: Not applicable.
METHODS: Retrospective literature review.
RESULTS: The anatomic elements of the craniocervical junction include the occipital bone, occipital condyles, atlas (C1), and axis (C2). The occiput-C1 and C1-C2 motion segments possess unique mechanical properties. Occipitocervical instrumentation constructs are comprised of points of fixation and longitudinal elements, each with characteristic strengths and weaknesses.
CONCLUSIONS: Analysis of the anatomy, available points of fixation, and the movements to be controlled leads to the choice of a longitudinal element which can control movement by incorporating the strongest points of fixation. By going through this process for each patient, an informed decision may be made regarding the optimal occipitocervical instrumentation construct.
Author List
Wolfla CEAuthor
Christopher E. Wolfla MD Professor in the Neurosurgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Biomechanical PhenomenaCervical Vertebrae
Humans
Joint Instability
Occipital Bone
Orthopedic Fixation Devices