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Biomechanical evaluation of the Total Atlanto-odontoid Joint Arthroplasty System: An in vitro human cadaveric study.
MedLine Citation:
PMID:  23510840     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Atlanto-odontoid joint arthroplasty is a motion restoring procedure suggested as an alternative to rigid fixation after surgical decompression. The purpose of this study was to evaluate the kinematics and pullout strength of a novel Total Atlanto-odontoid Joint Arthroplasty System using human cadaveric specimens. METHODS: Nondestructive biomechanical tests were performed on 24 fresh craniocervical specimens separated into two groups: 1) the prosthesis implantation group and 2) Harms transoral atlantoaxial plate fixation group. The following configurations were investigated: intact, after decompression, and instrumented. Range of motion and neutral zone were calculated for the C1-C2 segment. In a second experimental series, 8 sets of fresh atlantoaxial specimens were used to test the pullout strength of the atlas-axis components. FINDINGS: Compared with Harms rigid fixation, the Total Atlanto-odontoid Joint Arthroplasty System significantly increased the range of motion and neutral zone in all directions (P<.001). In addition, compared with the intact state, the only significant change in the range of motion and neutral zone with the Total Atlanto-odontoid Joint Arthroplasty System implantation was an increase in lateral bending (P<.001). The pullout strength created by the anterior C2 transpedicular screw was greater than that of the C2 vertebral screw and C1 lateral mass screw (P<.001), and the C1 lateral mass screw was stiffer than the C2 vertebral screw (P=.02). INTERPRETATION: Biomechanical analyses suggest that the Total Atlanto-odontoid Joint Arthroplasty System was able to provide reliable fixation strength and preserve the normal kinematics of the C1-C2 segment after decompressive procedures.
Authors:
Xuan Cai; Xijing He; Haopeng Li; Dong Wang
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-16
Journal Detail:
Title:  Clinical biomechanics (Bristol, Avon)     Volume:  -     ISSN:  1879-1271     ISO Abbreviation:  Clin Biomech (Bristol, Avon)     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8611877     Medline TA:  Clin Biomech (Bristol, Avon)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Orthopaedic Surgery, Second Affiliated Hospital of Medical School of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
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