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Biomechanical evaluation of four different fixation techniques for a distractive flexion injury stage 3 of the cervical spine An in vitro human cadaveric model
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Surgical Sciences.
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In: SpineArticle in journal (Refereed) In press
Identifiers
URN: urn:nbn:se:uu:diva-90830OAI: oai:DiVA.org:uu-90830DiVA: diva2:163314
Available from: 2003-09-11 Created: 2003-09-11Bibliographically approved
In thesis
1. Biomechanical and Clinical Aspects on Fixation Techniques in the Cervical Spine
Open this publication in new window or tab >>Biomechanical and Clinical Aspects on Fixation Techniques in the Cervical Spine
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The present work is analyzing the general biomechanical aspects of fixation techniques in the upper and lower cervical spine along with clinical implications.

The in vitro biomechanical properties of five different posterior atlanto-axial fixation techniques are compared. They provided for either a one, two or three-point fixation between atlas and axes. A new device, the C1 claw was biomechanically tested, which allow for fixation without the need for a structural bone graft. The three-point reconstructions indicated superior biomechanical properties compared to all others.

The new C1 claw device was clinically evaluated in a series of 26 patients treated with a posterior C1-C2 fusion. There were no clinical or radiological failures in the series, Twenty-one patients out of twenty-three with any length of follow up either showed a solidly healed fusion or a healed fracture.

Distractive flexion (DF) injuries in the lower cervical spine treated with anterior plate alone were analyzed with respect to healing rate and complications in a consecutive series of 36 patients. Results indicated that DF injury stage 1 and 2 according to Allen and Ferguson healed without complication, whereas DF injuries stage 3 had a high frequency of failure, needing an additional posterior fixation.

The in vitro biomechanical properties of four different fixation techniques for a distractive flexion injury stage 3 were analyzed. The result indicated that anterior plate alone for fixation of a DF injury stage 3 is insufficient supporting the clinical finding in the previous study.

Adjacent level motion was analyzed following a one segment fusion in the lower cervical spine. Motion was found to increase in adjacent levels possibly contributing to accelerated degeneration.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2003. 37 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1286
Keyword
Medicine, Biomechanics, Atlanto-axial fusion, Distractive flexion injuries, cervical spine, adjacent level motion, Medicin
National Category
Dermatology and Venereal Diseases
Identifiers
urn:nbn:se:uu:diva-3574 (URN)91-554-5735-5 (ISBN)
Public defence
2003-10-17, Rosénsalen, ingång 95/96, Uppsala, 09:15
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Available from: 2003-09-11 Created: 2003-09-11Bibliographically approved

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