Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation

Objective To assess the biomechanical effect of lateral inclination C1 and C2 pedicle screws on the atlantoaxial fixation through vitro human cadaveric study. Methods From January 2016 to December 2017, fresh‐frozen cadaveric cervical spines with intact ligaments from eight donated cadavers at an average age of 71.5 ± 10.6 years, comprising of six males and two females, were collected. There were no fracture and congenital malformation in all specimens according to the imaging examination. The range of motion (ROM) of the specimens were tested in their intact condition and destabilized condition. Next, the specimens were randomly divided into two groups to ensure no differences in sex and age: Group 1 was medial inclination C1 pedicle screw and C2 pedicle screws (C1MPS‐C2PS) and Group 2 was lateral inclination C1 pedicle screw and C2 pedicle screws (C1LPS‐C2PS). The ROM of the fixation scenarios were recorded. Thereafter, all the specimens with fixation constructs were tested for 1,000 cycles of axial rotation and tensile loading to failure was carried out collinearly to the longitudinal axis of all the screws, the data were documented as screw pullout strength (SPS) in newtons. All the recorded data subjected to quantitative analysis. Results The ROM of specimens was increased significantly in destabilized condition and significantly reduced in fixation condition compared with intact condition. In C1LPS‐C2PS groups, the C1‐C2 cervical segment showed 3.96° ±1.21° and 3.75° ± 1.33° in flexion and extension direction, 2.85° ± 0.91° and 2.96° ± 0.71° in right and left lateral bending, 2.20° ± 0.43° and 2.15° ± 0.40° in right and left axial rotation. In C1MPS‐C2PS groups, it showed 4.24° ±1.31° and 3.98° ± 1.21° in flexion and extension direction, 2.76° ± 1.10° and 3.23° ± 0.62° in right and left lateral bending, 2.20° ± 0.46° and 2.21° ± 0.42° in right and left axial rotation. There was no statistically significant difference on ROM and screw pullout strengths (764.29 ± 129.00 N vs 714.55 ± 164.63 N) between the two groups. However, there was one specimen in the C1MPS‐C2PS group showing rupture the inferior wall of the left screw trajectory owing to the relatively thin posterior arch of the atlas, the screw pullout strength was significantly reduced (left pullout strength value: 430.5 N, right pullout strength value: 748.4 N). Therefore, in the case of the thin posterior arch of the atlas, the C1LPS‐C2PS group had strong long‐term biomechanics. Conclusion The lateral inclination C1 pedicle screw can achieve the same biomechanical strength as the traditional atlas pedicle screw. However, for the case where the posterior arch of the atlas is relatively thin, a lateral inclination C1 pedicle screw is more suitable. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Lei Zhang [verfasserIn] Huan Wang [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	Atlantoaxial fixation Cadaveric study Lateral inclination C1 pedicle screw Lateral inclination C2 pedicle screw Narrow C1 posterior arch

Übergeordnetes Werk:	In: Orthopaedic Surgery - Wiley, 2019, 13(2021), 7, Seite 2027-2033
Übergeordnetes Werk:	volume:13 ; year:2021 ; number:7 ; pages:2027-2033

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.1111/os.13137

Katalog-ID:	DOAJ054746507

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520			\|a Objective To assess the biomechanical effect of lateral inclination C1 and C2 pedicle screws on the atlantoaxial fixation through vitro human cadaveric study. Methods From January 2016 to December 2017, fresh‐frozen cadaveric cervical spines with intact ligaments from eight donated cadavers at an average age of 71.5 ± 10.6 years, comprising of six males and two females, were collected. There were no fracture and congenital malformation in all specimens according to the imaging examination. The range of motion (ROM) of the specimens were tested in their intact condition and destabilized condition. Next, the specimens were randomly divided into two groups to ensure no differences in sex and age: Group 1 was medial inclination C1 pedicle screw and C2 pedicle screws (C1MPS‐C2PS) and Group 2 was lateral inclination C1 pedicle screw and C2 pedicle screws (C1LPS‐C2PS). The ROM of the fixation scenarios were recorded. Thereafter, all the specimens with fixation constructs were tested for 1,000 cycles of axial rotation and tensile loading to failure was carried out collinearly to the longitudinal axis of all the screws, the data were documented as screw pullout strength (SPS) in newtons. All the recorded data subjected to quantitative analysis. Results The ROM of specimens was increased significantly in destabilized condition and significantly reduced in fixation condition compared with intact condition. In C1LPS‐C2PS groups, the C1‐C2 cervical segment showed 3.96° ±1.21° and 3.75° ± 1.33° in flexion and extension direction, 2.85° ± 0.91° and 2.96° ± 0.71° in right and left lateral bending, 2.20° ± 0.43° and 2.15° ± 0.40° in right and left axial rotation. In C1MPS‐C2PS groups, it showed 4.24° ±1.31° and 3.98° ± 1.21° in flexion and extension direction, 2.76° ± 1.10° and 3.23° ± 0.62° in right and left lateral bending, 2.20° ± 0.46° and 2.21° ± 0.42° in right and left axial rotation. There was no statistically significant difference on ROM and screw pullout strengths (764.29 ± 129.00 N vs 714.55 ± 164.63 N) between the two groups. However, there was one specimen in the C1MPS‐C2PS group showing rupture the inferior wall of the left screw trajectory owing to the relatively thin posterior arch of the atlas, the screw pullout strength was significantly reduced (left pullout strength value: 430.5 N, right pullout strength value: 748.4 N). Therefore, in the case of the thin posterior arch of the atlas, the C1LPS‐C2PS group had strong long‐term biomechanics. Conclusion The lateral inclination C1 pedicle screw can achieve the same biomechanical strength as the traditional atlas pedicle screw. However, for the case where the posterior arch of the atlas is relatively thin, a lateral inclination C1 pedicle screw is more suitable.
650		4	\|a Atlantoaxial fixation
650		4	\|a Cadaveric study
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650		4	\|a Narrow C1 posterior arch
653		0	\|a Orthopedic surgery
700	0		\|a Huan Wang \|e verfasserin \|4 aut
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allfields	10.1111/os.13137 doi (DE-627)DOAJ054746507 (DE-599)DOAJe60653efd2f742e487e2ee32dce83d82 DE-627 ger DE-627 rakwb eng RD701-811 Lei Zhang verfasserin aut Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective To assess the biomechanical effect of lateral inclination C1 and C2 pedicle screws on the atlantoaxial fixation through vitro human cadaveric study. Methods From January 2016 to December 2017, fresh‐frozen cadaveric cervical spines with intact ligaments from eight donated cadavers at an average age of 71.5 ± 10.6 years, comprising of six males and two females, were collected. There were no fracture and congenital malformation in all specimens according to the imaging examination. The range of motion (ROM) of the specimens were tested in their intact condition and destabilized condition. Next, the specimens were randomly divided into two groups to ensure no differences in sex and age: Group 1 was medial inclination C1 pedicle screw and C2 pedicle screws (C1MPS‐C2PS) and Group 2 was lateral inclination C1 pedicle screw and C2 pedicle screws (C1LPS‐C2PS). The ROM of the fixation scenarios were recorded. Thereafter, all the specimens with fixation constructs were tested for 1,000 cycles of axial rotation and tensile loading to failure was carried out collinearly to the longitudinal axis of all the screws, the data were documented as screw pullout strength (SPS) in newtons. All the recorded data subjected to quantitative analysis. Results The ROM of specimens was increased significantly in destabilized condition and significantly reduced in fixation condition compared with intact condition. In C1LPS‐C2PS groups, the C1‐C2 cervical segment showed 3.96° ±1.21° and 3.75° ± 1.33° in flexion and extension direction, 2.85° ± 0.91° and 2.96° ± 0.71° in right and left lateral bending, 2.20° ± 0.43° and 2.15° ± 0.40° in right and left axial rotation. In C1MPS‐C2PS groups, it showed 4.24° ±1.31° and 3.98° ± 1.21° in flexion and extension direction, 2.76° ± 1.10° and 3.23° ± 0.62° in right and left lateral bending, 2.20° ± 0.46° and 2.21° ± 0.42° in right and left axial rotation. There was no statistically significant difference on ROM and screw pullout strengths (764.29 ± 129.00 N vs 714.55 ± 164.63 N) between the two groups. However, there was one specimen in the C1MPS‐C2PS group showing rupture the inferior wall of the left screw trajectory owing to the relatively thin posterior arch of the atlas, the screw pullout strength was significantly reduced (left pullout strength value: 430.5 N, right pullout strength value: 748.4 N). Therefore, in the case of the thin posterior arch of the atlas, the C1LPS‐C2PS group had strong long‐term biomechanics. Conclusion The lateral inclination C1 pedicle screw can achieve the same biomechanical strength as the traditional atlas pedicle screw. However, for the case where the posterior arch of the atlas is relatively thin, a lateral inclination C1 pedicle screw is more suitable. Atlantoaxial fixation Cadaveric study Lateral inclination C1 pedicle screw Lateral inclination C2 pedicle screw Narrow C1 posterior arch Orthopedic surgery Huan Wang verfasserin aut In Orthopaedic Surgery Wiley, 2019 13(2021), 7, Seite 2027-2033 (DE-627)59356393X (DE-600)2483883-4 17577861 nnns volume:13 year:2021 number:7 pages:2027-2033 https://doi.org/10.1111/os.13137 kostenfrei https://doaj.org/article/e60653efd2f742e487e2ee32dce83d82 kostenfrei https://doi.org/10.1111/os.13137 kostenfrei https://doaj.org/toc/1757-7853 Journal toc kostenfrei https://doaj.org/toc/1757-7861 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_636 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2021 7 2027-2033
spelling	10.1111/os.13137 doi (DE-627)DOAJ054746507 (DE-599)DOAJe60653efd2f742e487e2ee32dce83d82 DE-627 ger DE-627 rakwb eng RD701-811 Lei Zhang verfasserin aut Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective To assess the biomechanical effect of lateral inclination C1 and C2 pedicle screws on the atlantoaxial fixation through vitro human cadaveric study. Methods From January 2016 to December 2017, fresh‐frozen cadaveric cervical spines with intact ligaments from eight donated cadavers at an average age of 71.5 ± 10.6 years, comprising of six males and two females, were collected. There were no fracture and congenital malformation in all specimens according to the imaging examination. The range of motion (ROM) of the specimens were tested in their intact condition and destabilized condition. Next, the specimens were randomly divided into two groups to ensure no differences in sex and age: Group 1 was medial inclination C1 pedicle screw and C2 pedicle screws (C1MPS‐C2PS) and Group 2 was lateral inclination C1 pedicle screw and C2 pedicle screws (C1LPS‐C2PS). The ROM of the fixation scenarios were recorded. Thereafter, all the specimens with fixation constructs were tested for 1,000 cycles of axial rotation and tensile loading to failure was carried out collinearly to the longitudinal axis of all the screws, the data were documented as screw pullout strength (SPS) in newtons. All the recorded data subjected to quantitative analysis. Results The ROM of specimens was increased significantly in destabilized condition and significantly reduced in fixation condition compared with intact condition. In C1LPS‐C2PS groups, the C1‐C2 cervical segment showed 3.96° ±1.21° and 3.75° ± 1.33° in flexion and extension direction, 2.85° ± 0.91° and 2.96° ± 0.71° in right and left lateral bending, 2.20° ± 0.43° and 2.15° ± 0.40° in right and left axial rotation. In C1MPS‐C2PS groups, it showed 4.24° ±1.31° and 3.98° ± 1.21° in flexion and extension direction, 2.76° ± 1.10° and 3.23° ± 0.62° in right and left lateral bending, 2.20° ± 0.46° and 2.21° ± 0.42° in right and left axial rotation. There was no statistically significant difference on ROM and screw pullout strengths (764.29 ± 129.00 N vs 714.55 ± 164.63 N) between the two groups. However, there was one specimen in the C1MPS‐C2PS group showing rupture the inferior wall of the left screw trajectory owing to the relatively thin posterior arch of the atlas, the screw pullout strength was significantly reduced (left pullout strength value: 430.5 N, right pullout strength value: 748.4 N). Therefore, in the case of the thin posterior arch of the atlas, the C1LPS‐C2PS group had strong long‐term biomechanics. Conclusion The lateral inclination C1 pedicle screw can achieve the same biomechanical strength as the traditional atlas pedicle screw. However, for the case where the posterior arch of the atlas is relatively thin, a lateral inclination C1 pedicle screw is more suitable. Atlantoaxial fixation Cadaveric study Lateral inclination C1 pedicle screw Lateral inclination C2 pedicle screw Narrow C1 posterior arch Orthopedic surgery Huan Wang verfasserin aut In Orthopaedic Surgery Wiley, 2019 13(2021), 7, Seite 2027-2033 (DE-627)59356393X (DE-600)2483883-4 17577861 nnns volume:13 year:2021 number:7 pages:2027-2033 https://doi.org/10.1111/os.13137 kostenfrei https://doaj.org/article/e60653efd2f742e487e2ee32dce83d82 kostenfrei https://doi.org/10.1111/os.13137 kostenfrei https://doaj.org/toc/1757-7853 Journal toc kostenfrei https://doaj.org/toc/1757-7861 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_636 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2021 7 2027-2033
allfields_unstemmed	10.1111/os.13137 doi (DE-627)DOAJ054746507 (DE-599)DOAJe60653efd2f742e487e2ee32dce83d82 DE-627 ger DE-627 rakwb eng RD701-811 Lei Zhang verfasserin aut Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective To assess the biomechanical effect of lateral inclination C1 and C2 pedicle screws on the atlantoaxial fixation through vitro human cadaveric study. Methods From January 2016 to December 2017, fresh‐frozen cadaveric cervical spines with intact ligaments from eight donated cadavers at an average age of 71.5 ± 10.6 years, comprising of six males and two females, were collected. There were no fracture and congenital malformation in all specimens according to the imaging examination. The range of motion (ROM) of the specimens were tested in their intact condition and destabilized condition. Next, the specimens were randomly divided into two groups to ensure no differences in sex and age: Group 1 was medial inclination C1 pedicle screw and C2 pedicle screws (C1MPS‐C2PS) and Group 2 was lateral inclination C1 pedicle screw and C2 pedicle screws (C1LPS‐C2PS). The ROM of the fixation scenarios were recorded. Thereafter, all the specimens with fixation constructs were tested for 1,000 cycles of axial rotation and tensile loading to failure was carried out collinearly to the longitudinal axis of all the screws, the data were documented as screw pullout strength (SPS) in newtons. All the recorded data subjected to quantitative analysis. Results The ROM of specimens was increased significantly in destabilized condition and significantly reduced in fixation condition compared with intact condition. In C1LPS‐C2PS groups, the C1‐C2 cervical segment showed 3.96° ±1.21° and 3.75° ± 1.33° in flexion and extension direction, 2.85° ± 0.91° and 2.96° ± 0.71° in right and left lateral bending, 2.20° ± 0.43° and 2.15° ± 0.40° in right and left axial rotation. In C1MPS‐C2PS groups, it showed 4.24° ±1.31° and 3.98° ± 1.21° in flexion and extension direction, 2.76° ± 1.10° and 3.23° ± 0.62° in right and left lateral bending, 2.20° ± 0.46° and 2.21° ± 0.42° in right and left axial rotation. There was no statistically significant difference on ROM and screw pullout strengths (764.29 ± 129.00 N vs 714.55 ± 164.63 N) between the two groups. However, there was one specimen in the C1MPS‐C2PS group showing rupture the inferior wall of the left screw trajectory owing to the relatively thin posterior arch of the atlas, the screw pullout strength was significantly reduced (left pullout strength value: 430.5 N, right pullout strength value: 748.4 N). Therefore, in the case of the thin posterior arch of the atlas, the C1LPS‐C2PS group had strong long‐term biomechanics. Conclusion The lateral inclination C1 pedicle screw can achieve the same biomechanical strength as the traditional atlas pedicle screw. However, for the case where the posterior arch of the atlas is relatively thin, a lateral inclination C1 pedicle screw is more suitable. Atlantoaxial fixation Cadaveric study Lateral inclination C1 pedicle screw Lateral inclination C2 pedicle screw Narrow C1 posterior arch Orthopedic surgery Huan Wang verfasserin aut In Orthopaedic Surgery Wiley, 2019 13(2021), 7, Seite 2027-2033 (DE-627)59356393X (DE-600)2483883-4 17577861 nnns volume:13 year:2021 number:7 pages:2027-2033 https://doi.org/10.1111/os.13137 kostenfrei https://doaj.org/article/e60653efd2f742e487e2ee32dce83d82 kostenfrei https://doi.org/10.1111/os.13137 kostenfrei https://doaj.org/toc/1757-7853 Journal toc kostenfrei https://doaj.org/toc/1757-7861 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_636 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2021 7 2027-2033
allfieldsGer	10.1111/os.13137 doi (DE-627)DOAJ054746507 (DE-599)DOAJe60653efd2f742e487e2ee32dce83d82 DE-627 ger DE-627 rakwb eng RD701-811 Lei Zhang verfasserin aut Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective To assess the biomechanical effect of lateral inclination C1 and C2 pedicle screws on the atlantoaxial fixation through vitro human cadaveric study. Methods From January 2016 to December 2017, fresh‐frozen cadaveric cervical spines with intact ligaments from eight donated cadavers at an average age of 71.5 ± 10.6 years, comprising of six males and two females, were collected. There were no fracture and congenital malformation in all specimens according to the imaging examination. The range of motion (ROM) of the specimens were tested in their intact condition and destabilized condition. Next, the specimens were randomly divided into two groups to ensure no differences in sex and age: Group 1 was medial inclination C1 pedicle screw and C2 pedicle screws (C1MPS‐C2PS) and Group 2 was lateral inclination C1 pedicle screw and C2 pedicle screws (C1LPS‐C2PS). The ROM of the fixation scenarios were recorded. Thereafter, all the specimens with fixation constructs were tested for 1,000 cycles of axial rotation and tensile loading to failure was carried out collinearly to the longitudinal axis of all the screws, the data were documented as screw pullout strength (SPS) in newtons. All the recorded data subjected to quantitative analysis. Results The ROM of specimens was increased significantly in destabilized condition and significantly reduced in fixation condition compared with intact condition. In C1LPS‐C2PS groups, the C1‐C2 cervical segment showed 3.96° ±1.21° and 3.75° ± 1.33° in flexion and extension direction, 2.85° ± 0.91° and 2.96° ± 0.71° in right and left lateral bending, 2.20° ± 0.43° and 2.15° ± 0.40° in right and left axial rotation. In C1MPS‐C2PS groups, it showed 4.24° ±1.31° and 3.98° ± 1.21° in flexion and extension direction, 2.76° ± 1.10° and 3.23° ± 0.62° in right and left lateral bending, 2.20° ± 0.46° and 2.21° ± 0.42° in right and left axial rotation. There was no statistically significant difference on ROM and screw pullout strengths (764.29 ± 129.00 N vs 714.55 ± 164.63 N) between the two groups. However, there was one specimen in the C1MPS‐C2PS group showing rupture the inferior wall of the left screw trajectory owing to the relatively thin posterior arch of the atlas, the screw pullout strength was significantly reduced (left pullout strength value: 430.5 N, right pullout strength value: 748.4 N). Therefore, in the case of the thin posterior arch of the atlas, the C1LPS‐C2PS group had strong long‐term biomechanics. Conclusion The lateral inclination C1 pedicle screw can achieve the same biomechanical strength as the traditional atlas pedicle screw. However, for the case where the posterior arch of the atlas is relatively thin, a lateral inclination C1 pedicle screw is more suitable. Atlantoaxial fixation Cadaveric study Lateral inclination C1 pedicle screw Lateral inclination C2 pedicle screw Narrow C1 posterior arch Orthopedic surgery Huan Wang verfasserin aut In Orthopaedic Surgery Wiley, 2019 13(2021), 7, Seite 2027-2033 (DE-627)59356393X (DE-600)2483883-4 17577861 nnns volume:13 year:2021 number:7 pages:2027-2033 https://doi.org/10.1111/os.13137 kostenfrei https://doaj.org/article/e60653efd2f742e487e2ee32dce83d82 kostenfrei https://doi.org/10.1111/os.13137 kostenfrei https://doaj.org/toc/1757-7853 Journal toc kostenfrei https://doaj.org/toc/1757-7861 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_636 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2021 7 2027-2033
allfieldsSound	10.1111/os.13137 doi (DE-627)DOAJ054746507 (DE-599)DOAJe60653efd2f742e487e2ee32dce83d82 DE-627 ger DE-627 rakwb eng RD701-811 Lei Zhang verfasserin aut Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective To assess the biomechanical effect of lateral inclination C1 and C2 pedicle screws on the atlantoaxial fixation through vitro human cadaveric study. Methods From January 2016 to December 2017, fresh‐frozen cadaveric cervical spines with intact ligaments from eight donated cadavers at an average age of 71.5 ± 10.6 years, comprising of six males and two females, were collected. There were no fracture and congenital malformation in all specimens according to the imaging examination. The range of motion (ROM) of the specimens were tested in their intact condition and destabilized condition. Next, the specimens were randomly divided into two groups to ensure no differences in sex and age: Group 1 was medial inclination C1 pedicle screw and C2 pedicle screws (C1MPS‐C2PS) and Group 2 was lateral inclination C1 pedicle screw and C2 pedicle screws (C1LPS‐C2PS). The ROM of the fixation scenarios were recorded. Thereafter, all the specimens with fixation constructs were tested for 1,000 cycles of axial rotation and tensile loading to failure was carried out collinearly to the longitudinal axis of all the screws, the data were documented as screw pullout strength (SPS) in newtons. All the recorded data subjected to quantitative analysis. Results The ROM of specimens was increased significantly in destabilized condition and significantly reduced in fixation condition compared with intact condition. In C1LPS‐C2PS groups, the C1‐C2 cervical segment showed 3.96° ±1.21° and 3.75° ± 1.33° in flexion and extension direction, 2.85° ± 0.91° and 2.96° ± 0.71° in right and left lateral bending, 2.20° ± 0.43° and 2.15° ± 0.40° in right and left axial rotation. In C1MPS‐C2PS groups, it showed 4.24° ±1.31° and 3.98° ± 1.21° in flexion and extension direction, 2.76° ± 1.10° and 3.23° ± 0.62° in right and left lateral bending, 2.20° ± 0.46° and 2.21° ± 0.42° in right and left axial rotation. There was no statistically significant difference on ROM and screw pullout strengths (764.29 ± 129.00 N vs 714.55 ± 164.63 N) between the two groups. However, there was one specimen in the C1MPS‐C2PS group showing rupture the inferior wall of the left screw trajectory owing to the relatively thin posterior arch of the atlas, the screw pullout strength was significantly reduced (left pullout strength value: 430.5 N, right pullout strength value: 748.4 N). Therefore, in the case of the thin posterior arch of the atlas, the C1LPS‐C2PS group had strong long‐term biomechanics. Conclusion The lateral inclination C1 pedicle screw can achieve the same biomechanical strength as the traditional atlas pedicle screw. However, for the case where the posterior arch of the atlas is relatively thin, a lateral inclination C1 pedicle screw is more suitable. Atlantoaxial fixation Cadaveric study Lateral inclination C1 pedicle screw Lateral inclination C2 pedicle screw Narrow C1 posterior arch Orthopedic surgery Huan Wang verfasserin aut In Orthopaedic Surgery Wiley, 2019 13(2021), 7, Seite 2027-2033 (DE-627)59356393X (DE-600)2483883-4 17577861 nnns volume:13 year:2021 number:7 pages:2027-2033 https://doi.org/10.1111/os.13137 kostenfrei https://doaj.org/article/e60653efd2f742e487e2ee32dce83d82 kostenfrei https://doi.org/10.1111/os.13137 kostenfrei https://doaj.org/toc/1757-7853 Journal toc kostenfrei https://doaj.org/toc/1757-7861 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_636 GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2232 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2021 7 2027-2033
language	English
source	In Orthopaedic Surgery 13(2021), 7, Seite 2027-2033 volume:13 year:2021 number:7 pages:2027-2033
sourceStr	In Orthopaedic Surgery 13(2021), 7, Seite 2027-2033 volume:13 year:2021 number:7 pages:2027-2033
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Atlantoaxial fixation Cadaveric study Lateral inclination C1 pedicle screw Lateral inclination C2 pedicle screw Narrow C1 posterior arch Orthopedic surgery
isfreeaccess_bool	true
container_title	Orthopaedic Surgery
authorswithroles_txt_mv	Lei Zhang @@aut@@ Huan Wang @@aut@@
publishDateDaySort_date	2021-01-01T00:00:00Z
hierarchy_top_id	59356393X
id	DOAJ054746507
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ054746507</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230308184015.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230227s2021 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1111/os.13137</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ054746507</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJe60653efd2f742e487e2ee32dce83d82</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RD701-811</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Lei Zhang</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2021</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Objective To assess the biomechanical effect of lateral inclination C1 and C2 pedicle screws on the atlantoaxial fixation through vitro human cadaveric study. Methods From January 2016 to December 2017, fresh‐frozen cadaveric cervical spines with intact ligaments from eight donated cadavers at an average age of 71.5 ± 10.6 years, comprising of six males and two females, were collected. There were no fracture and congenital malformation in all specimens according to the imaging examination. The range of motion (ROM) of the specimens were tested in their intact condition and destabilized condition. Next, the specimens were randomly divided into two groups to ensure no differences in sex and age: Group 1 was medial inclination C1 pedicle screw and C2 pedicle screws (C1MPS‐C2PS) and Group 2 was lateral inclination C1 pedicle screw and C2 pedicle screws (C1LPS‐C2PS). The ROM of the fixation scenarios were recorded. Thereafter, all the specimens with fixation constructs were tested for 1,000 cycles of axial rotation and tensile loading to failure was carried out collinearly to the longitudinal axis of all the screws, the data were documented as screw pullout strength (SPS) in newtons. All the recorded data subjected to quantitative analysis. Results The ROM of specimens was increased significantly in destabilized condition and significantly reduced in fixation condition compared with intact condition. In C1LPS‐C2PS groups, the C1‐C2 cervical segment showed 3.96° ±1.21° and 3.75° ± 1.33° in flexion and extension direction, 2.85° ± 0.91° and 2.96° ± 0.71° in right and left lateral bending, 2.20° ± 0.43° and 2.15° ± 0.40° in right and left axial rotation. In C1MPS‐C2PS groups, it showed 4.24° ±1.31° and 3.98° ± 1.21° in flexion and extension direction, 2.76° ± 1.10° and 3.23° ± 0.62° in right and left lateral bending, 2.20° ± 0.46° and 2.21° ± 0.42° in right and left axial rotation. There was no statistically significant difference on ROM and screw pullout strengths (764.29 ± 129.00 N vs 714.55 ± 164.63 N) between the two groups. However, there was one specimen in the C1MPS‐C2PS group showing rupture the inferior wall of the left screw trajectory owing to the relatively thin posterior arch of the atlas, the screw pullout strength was significantly reduced (left pullout strength value: 430.5 N, right pullout strength value: 748.4 N). Therefore, in the case of the thin posterior arch of the atlas, the C1LPS‐C2PS group had strong long‐term biomechanics. Conclusion The lateral inclination C1 pedicle screw can achieve the same biomechanical strength as the traditional atlas pedicle screw. However, for the case where the posterior arch of the atlas is relatively thin, a lateral inclination C1 pedicle screw is more suitable.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Atlantoaxial fixation</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Cadaveric study</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Lateral inclination C1 pedicle screw</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Lateral inclination C2 pedicle screw</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Narrow C1 posterior arch</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Orthopedic surgery</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Huan Wang</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" 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callnumber-first	R - Medicine
author	Lei Zhang
spellingShingle	Lei Zhang misc RD701-811 misc Atlantoaxial fixation misc Cadaveric study misc Lateral inclination C1 pedicle screw misc Lateral inclination C2 pedicle screw misc Narrow C1 posterior arch misc Orthopedic surgery Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation
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topic_title	RD701-811 Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation Atlantoaxial fixation Cadaveric study Lateral inclination C1 pedicle screw Lateral inclination C2 pedicle screw Narrow C1 posterior arch
topic	misc RD701-811 misc Atlantoaxial fixation misc Cadaveric study misc Lateral inclination C1 pedicle screw misc Lateral inclination C2 pedicle screw misc Narrow C1 posterior arch misc Orthopedic surgery
topic_unstemmed	misc RD701-811 misc Atlantoaxial fixation misc Cadaveric study misc Lateral inclination C1 pedicle screw misc Lateral inclination C2 pedicle screw misc Narrow C1 posterior arch misc Orthopedic surgery
topic_browse	misc RD701-811 misc Atlantoaxial fixation misc Cadaveric study misc Lateral inclination C1 pedicle screw misc Lateral inclination C2 pedicle screw misc Narrow C1 posterior arch misc Orthopedic surgery
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title	Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation
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title_full	Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation
author_sort	Lei Zhang
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title_sort	biomechanical effects of lateral inclination c1 and c2 pedicle screws on atlantoaxial fixation
callnumber	RD701-811
title_auth	Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation
abstract	Objective To assess the biomechanical effect of lateral inclination C1 and C2 pedicle screws on the atlantoaxial fixation through vitro human cadaveric study. Methods From January 2016 to December 2017, fresh‐frozen cadaveric cervical spines with intact ligaments from eight donated cadavers at an average age of 71.5 ± 10.6 years, comprising of six males and two females, were collected. There were no fracture and congenital malformation in all specimens according to the imaging examination. The range of motion (ROM) of the specimens were tested in their intact condition and destabilized condition. Next, the specimens were randomly divided into two groups to ensure no differences in sex and age: Group 1 was medial inclination C1 pedicle screw and C2 pedicle screws (C1MPS‐C2PS) and Group 2 was lateral inclination C1 pedicle screw and C2 pedicle screws (C1LPS‐C2PS). The ROM of the fixation scenarios were recorded. Thereafter, all the specimens with fixation constructs were tested for 1,000 cycles of axial rotation and tensile loading to failure was carried out collinearly to the longitudinal axis of all the screws, the data were documented as screw pullout strength (SPS) in newtons. All the recorded data subjected to quantitative analysis. Results The ROM of specimens was increased significantly in destabilized condition and significantly reduced in fixation condition compared with intact condition. In C1LPS‐C2PS groups, the C1‐C2 cervical segment showed 3.96° ±1.21° and 3.75° ± 1.33° in flexion and extension direction, 2.85° ± 0.91° and 2.96° ± 0.71° in right and left lateral bending, 2.20° ± 0.43° and 2.15° ± 0.40° in right and left axial rotation. In C1MPS‐C2PS groups, it showed 4.24° ±1.31° and 3.98° ± 1.21° in flexion and extension direction, 2.76° ± 1.10° and 3.23° ± 0.62° in right and left lateral bending, 2.20° ± 0.46° and 2.21° ± 0.42° in right and left axial rotation. There was no statistically significant difference on ROM and screw pullout strengths (764.29 ± 129.00 N vs 714.55 ± 164.63 N) between the two groups. However, there was one specimen in the C1MPS‐C2PS group showing rupture the inferior wall of the left screw trajectory owing to the relatively thin posterior arch of the atlas, the screw pullout strength was significantly reduced (left pullout strength value: 430.5 N, right pullout strength value: 748.4 N). Therefore, in the case of the thin posterior arch of the atlas, the C1LPS‐C2PS group had strong long‐term biomechanics. Conclusion The lateral inclination C1 pedicle screw can achieve the same biomechanical strength as the traditional atlas pedicle screw. However, for the case where the posterior arch of the atlas is relatively thin, a lateral inclination C1 pedicle screw is more suitable.
abstractGer	Objective To assess the biomechanical effect of lateral inclination C1 and C2 pedicle screws on the atlantoaxial fixation through vitro human cadaveric study. Methods From January 2016 to December 2017, fresh‐frozen cadaveric cervical spines with intact ligaments from eight donated cadavers at an average age of 71.5 ± 10.6 years, comprising of six males and two females, were collected. There were no fracture and congenital malformation in all specimens according to the imaging examination. The range of motion (ROM) of the specimens were tested in their intact condition and destabilized condition. Next, the specimens were randomly divided into two groups to ensure no differences in sex and age: Group 1 was medial inclination C1 pedicle screw and C2 pedicle screws (C1MPS‐C2PS) and Group 2 was lateral inclination C1 pedicle screw and C2 pedicle screws (C1LPS‐C2PS). The ROM of the fixation scenarios were recorded. Thereafter, all the specimens with fixation constructs were tested for 1,000 cycles of axial rotation and tensile loading to failure was carried out collinearly to the longitudinal axis of all the screws, the data were documented as screw pullout strength (SPS) in newtons. All the recorded data subjected to quantitative analysis. Results The ROM of specimens was increased significantly in destabilized condition and significantly reduced in fixation condition compared with intact condition. In C1LPS‐C2PS groups, the C1‐C2 cervical segment showed 3.96° ±1.21° and 3.75° ± 1.33° in flexion and extension direction, 2.85° ± 0.91° and 2.96° ± 0.71° in right and left lateral bending, 2.20° ± 0.43° and 2.15° ± 0.40° in right and left axial rotation. In C1MPS‐C2PS groups, it showed 4.24° ±1.31° and 3.98° ± 1.21° in flexion and extension direction, 2.76° ± 1.10° and 3.23° ± 0.62° in right and left lateral bending, 2.20° ± 0.46° and 2.21° ± 0.42° in right and left axial rotation. There was no statistically significant difference on ROM and screw pullout strengths (764.29 ± 129.00 N vs 714.55 ± 164.63 N) between the two groups. However, there was one specimen in the C1MPS‐C2PS group showing rupture the inferior wall of the left screw trajectory owing to the relatively thin posterior arch of the atlas, the screw pullout strength was significantly reduced (left pullout strength value: 430.5 N, right pullout strength value: 748.4 N). Therefore, in the case of the thin posterior arch of the atlas, the C1LPS‐C2PS group had strong long‐term biomechanics. Conclusion The lateral inclination C1 pedicle screw can achieve the same biomechanical strength as the traditional atlas pedicle screw. However, for the case where the posterior arch of the atlas is relatively thin, a lateral inclination C1 pedicle screw is more suitable.
abstract_unstemmed	Objective To assess the biomechanical effect of lateral inclination C1 and C2 pedicle screws on the atlantoaxial fixation through vitro human cadaveric study. Methods From January 2016 to December 2017, fresh‐frozen cadaveric cervical spines with intact ligaments from eight donated cadavers at an average age of 71.5 ± 10.6 years, comprising of six males and two females, were collected. There were no fracture and congenital malformation in all specimens according to the imaging examination. The range of motion (ROM) of the specimens were tested in their intact condition and destabilized condition. Next, the specimens were randomly divided into two groups to ensure no differences in sex and age: Group 1 was medial inclination C1 pedicle screw and C2 pedicle screws (C1MPS‐C2PS) and Group 2 was lateral inclination C1 pedicle screw and C2 pedicle screws (C1LPS‐C2PS). The ROM of the fixation scenarios were recorded. Thereafter, all the specimens with fixation constructs were tested for 1,000 cycles of axial rotation and tensile loading to failure was carried out collinearly to the longitudinal axis of all the screws, the data were documented as screw pullout strength (SPS) in newtons. All the recorded data subjected to quantitative analysis. Results The ROM of specimens was increased significantly in destabilized condition and significantly reduced in fixation condition compared with intact condition. In C1LPS‐C2PS groups, the C1‐C2 cervical segment showed 3.96° ±1.21° and 3.75° ± 1.33° in flexion and extension direction, 2.85° ± 0.91° and 2.96° ± 0.71° in right and left lateral bending, 2.20° ± 0.43° and 2.15° ± 0.40° in right and left axial rotation. In C1MPS‐C2PS groups, it showed 4.24° ±1.31° and 3.98° ± 1.21° in flexion and extension direction, 2.76° ± 1.10° and 3.23° ± 0.62° in right and left lateral bending, 2.20° ± 0.46° and 2.21° ± 0.42° in right and left axial rotation. There was no statistically significant difference on ROM and screw pullout strengths (764.29 ± 129.00 N vs 714.55 ± 164.63 N) between the two groups. However, there was one specimen in the C1MPS‐C2PS group showing rupture the inferior wall of the left screw trajectory owing to the relatively thin posterior arch of the atlas, the screw pullout strength was significantly reduced (left pullout strength value: 430.5 N, right pullout strength value: 748.4 N). Therefore, in the case of the thin posterior arch of the atlas, the C1LPS‐C2PS group had strong long‐term biomechanics. Conclusion The lateral inclination C1 pedicle screw can achieve the same biomechanical strength as the traditional atlas pedicle screw. However, for the case where the posterior arch of the atlas is relatively thin, a lateral inclination C1 pedicle screw is more suitable.
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title_short	Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation
url	https://doi.org/10.1111/os.13137 https://doaj.org/article/e60653efd2f742e487e2ee32dce83d82 https://doaj.org/toc/1757-7853 https://doaj.org/toc/1757-7861
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up_date	2024-07-04T00:26:18.931Z
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fullrecord_marcxml	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ054746507</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230308184015.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230227s2021 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1111/os.13137</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ054746507</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJe60653efd2f742e487e2ee32dce83d82</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RD701-811</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Lei Zhang</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2021</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Objective To assess the biomechanical effect of lateral inclination C1 and C2 pedicle screws on the atlantoaxial fixation through vitro human cadaveric study. Methods From January 2016 to December 2017, fresh‐frozen cadaveric cervical spines with intact ligaments from eight donated cadavers at an average age of 71.5 ± 10.6 years, comprising of six males and two females, were collected. There were no fracture and congenital malformation in all specimens according to the imaging examination. The range of motion (ROM) of the specimens were tested in their intact condition and destabilized condition. Next, the specimens were randomly divided into two groups to ensure no differences in sex and age: Group 1 was medial inclination C1 pedicle screw and C2 pedicle screws (C1MPS‐C2PS) and Group 2 was lateral inclination C1 pedicle screw and C2 pedicle screws (C1LPS‐C2PS). The ROM of the fixation scenarios were recorded. Thereafter, all the specimens with fixation constructs were tested for 1,000 cycles of axial rotation and tensile loading to failure was carried out collinearly to the longitudinal axis of all the screws, the data were documented as screw pullout strength (SPS) in newtons. All the recorded data subjected to quantitative analysis. Results The ROM of specimens was increased significantly in destabilized condition and significantly reduced in fixation condition compared with intact condition. In C1LPS‐C2PS groups, the C1‐C2 cervical segment showed 3.96° ±1.21° and 3.75° ± 1.33° in flexion and extension direction, 2.85° ± 0.91° and 2.96° ± 0.71° in right and left lateral bending, 2.20° ± 0.43° and 2.15° ± 0.40° in right and left axial rotation. In C1MPS‐C2PS groups, it showed 4.24° ±1.31° and 3.98° ± 1.21° in flexion and extension direction, 2.76° ± 1.10° and 3.23° ± 0.62° in right and left lateral bending, 2.20° ± 0.46° and 2.21° ± 0.42° in right and left axial rotation. There was no statistically significant difference on ROM and screw pullout strengths (764.29 ± 129.00 N vs 714.55 ± 164.63 N) between the two groups. However, there was one specimen in the C1MPS‐C2PS group showing rupture the inferior wall of the left screw trajectory owing to the relatively thin posterior arch of the atlas, the screw pullout strength was significantly reduced (left pullout strength value: 430.5 N, right pullout strength value: 748.4 N). Therefore, in the case of the thin posterior arch of the atlas, the C1LPS‐C2PS group had strong long‐term biomechanics. Conclusion The lateral inclination C1 pedicle screw can achieve the same biomechanical strength as the traditional atlas pedicle screw. However, for the case where the posterior arch of the atlas is relatively thin, a lateral inclination C1 pedicle screw is more suitable.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Atlantoaxial fixation</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Cadaveric study</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Lateral inclination C1 pedicle screw</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Lateral inclination C2 pedicle screw</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Narrow C1 posterior arch</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Orthopedic surgery</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Huan Wang</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" 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Biomechanical Effects of Lateral Inclination C1 and C2 Pedicle Screws on Atlantoaxial Fixation

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