Abstract
This study is about a biomechanical comparison of some stabilization solutions for the occipitocervical junction. Four kinds of occipito-cervical fixations are analysed in this work: lateral plates fixed by two kinds of screws, lateral plates fixed by hooks and median plate. To study mechanical rigidity of each one, tests have been performed on human skulls by applying loadings and by studying mechanical response of fixations and bone. For this experimental analysis, a specific setup has been developed to impose a load corresponding to the flexion-extension physiological movements. 3D mark tracking technique is employed to measure 3D displacement fields on the bone and on the fixations. Observations of displacement evolution on the bone according to the fixation show different rigidities given by each solution.
Highlights
Craniocervical junction can be rendered unstable because of various disease problems, stabilization from occipito-cervical fixation is necessary
Four kinds of occipito-cervical fixations are analysed in this work: lateral plates fixed by two kinds of screws, lateral plates fixed by hooks and median plate
The objective of this study is to analyse mechanical response of four different kinds of occipitocervical fixations: lateral plates fixed with screws, lateral plates fixed with screws with a smaller pitch, lateral plates fixed with hooks and median plate fixed with screws
Summary
Craniocervical junction can be rendered unstable because of various disease problems, stabilization from occipito-cervical fixation is necessary. Stabilization of the craniocervical junction consists in a rigid fixation between the occiput and upper cervical spine by using plates, rods and screws. Several works have already validated the contribution of the craniocervical junction according different pathologies [1,2,3,4,5,6]. Different kinds of fixations have been developed [5,6,7,8] in order to insure the stability of the junction like rods fixed on lateral plates associated screws or with hooks or on a median plate with screws. Fixations involve more or less safely operation according to the location of screw implantations. The variable local bone thickness of the occiput, combined with the location of the dural sinuses, dictates the safe working length for occipital screws, potentially affecting fixation strength and rigidity
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