Author:
Liu Yaoyao,Wang Zhong,Liu Mingyong,Yin Xiang,Liu Jiming,Zhao Jianhua,Liu Peng
Abstract
AbstractAnkylosing spondylitis cervical spine fractures (ASCFs) are particularly unstable and need special consideration when selecting appropriate internal fixation technology. However, there is a lack of related biomechanical studies. This study aimed to investigate the biomechanical influence of the pattern, length, and density of instrumentation for the treatment of ASCF. Posterior, anterior, and various combined fixation approaches were constructed using the finite element model (FEM) to mimic the surgical treatment of ASCFs at C5/6. The rate of motion change (RMC) at the fractured level and the internal stress distribution (ISD) were observed. The results showed that longer segments of fixation and combined fixation approaches provided better stability and lowered the maximal stress. The RMC decreased more significantly when the length increased from 1 to 3 levels (302% decrease under flexion, 134% decrease under extension) than from 3 to 5 levels (22% decrease under flexion, 23% decrease under extension). Longer fixation seems to be more stable with the anterior/posterior approach alone, but 3-level posterior fixation may be the most cost-effective option. It is recommended to perform surgery with combined approaches, which provide the best stability. Long skipped-screwing posterior fixation is an alternative technique for use in ASCF patients.
Funder
National Natural Science Foundation of China
Third Military Medical University
Publisher
Springer Science and Business Media LLC
Reference76 articles.
1. Calin, A. & Fries, J. F. Striking prevalence of ankylosing spondylitis in “healthy” w27 positive males and females. N. Engl. J. Med. 293(17), 835–839 (1975).
2. Broom, M. J. & Raycroft, J. F. Complications of fractures of the cervical spine in ankylosing spondylitis. Spine 13(7), 763–766 (1988).
3. Detwiler, K. N., Loftus, C. M., Godersky, J. C. & Menezes, A. H. Management of cervical spine injuries in patients with ankylosing spondylitis. J. Neurosurg. 72(2), 210–215 (1990).
4. Rowed, D. W. Management of cervical spinal cord injury in ankylosing spondylitis: The intervertebral disc as a cause of cord compression. J. Neurosurg. 77(2), 241–246 (1992).
5. Bronson, W. D. et al. Bone mineral density and biochemical markers of bone metabolism in ankylosing spondylitis. J. Rheumatol. 25(5), 929–935 (1998).
Cited by
6 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献