Abstract
BackgroundA novel implant for occipitocervical fusion consisting of a median plate with an additional hook inserting in the foramen magnum was tested. Aim of this study was to test the stability of a new implant for occipitocervical fusion against the already available and employed median plate implant without hook.Material and method36 rigid polyurethane foams occipital artificial bones were used. The two occipital implants, namely the occipital plate with hook (Group 1) and the one without hook (Group 2), were applied to the artificial occiput trough three occipital screws and ensured into the experimental setup trough a crossbar. The test parameters were set using the testing machine software as follows: (1) test speed: 10 mm/ min, with 25 mm/ min maximum; (2) preload: 5 N; (3) force switch-off threshold: 90% force drop from F_max. Failure force and path were recorded. Failure force is defined as the maximum reaction force under which failure occurs (F_max), while failure path is the travel path during which failure occurs (dL).ResultsGroup 1 (plate with hook) showed a mean failure force of 459.3 ± 35.9 N and a mean failure path of 5.8 ± 0.3 mm Group 2 (plate without hook) showed a mean failure force of 323.9 ± 20.2 N and a mean failure path of 7.2 ± 0.4 mm. The Shapiro-Wilk test score was not significant (P > 0.1), assuming that data were normally distributed. Group 1 had a statistically significant greater F_max (+ 135.37; P > 0.0001) and less dL (− 1.52; P > 0.0001) compared to group 2.ConclusionsMedial plates with foramen magnum hooks showed to be more stable that plates without a hook. These new implants may represent a new tool in OCJ fixation, but further studies are required to investigate their behavior in an anatomical setting.
Highlights
A novel implant for occipitocervical fusion consisting of a median plate with an additional hook inserting in the foramen magnum was tested
Medial plates with foramen magnum hooks showed to be more stable that plates without a hook
These new implants may represent a new tool in OCJ fixation, but further studies are required to investigate their behavior in an anatomical setting
Summary
A novel implant for occipitocervical fusion consisting of a median plate with an additional hook inserting in the foramen magnum was tested. Aim of this study was to test the stability of a new implant for occipitocervical fusion against the already available and employed median plate implant without hook. Most screw/plate constructs allow a degree of rotation of the screw head in respect to the plate, which over time can lead to reduction of the implant stability and, eventually, pullout [4]. For this reason, and to reduce iatrogenic complications such as lesion of the meningeal sheets or the venous plexus alternative implants such as occipital-condyle screw plates or bone hooks have been developed [8, 10, 11]
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