Biomechanical and Morphometric Evaluation of Occipital Condyle for Occipitocervical Segmental Fixation

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概要

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• Two recent novel techniques of occipital fixation are the occipitoatlantal (C0-C1) transarticular screw technique and the direct occipital condyle screw technique. The present study evaluated and compared the biomechanical stability of the direct occipital condyle screw and C0-C1 transarticular screw with the established method for craniocervical spine fixation using the midline occipital keel screw and C1 lateral mass screw. Morphometric evaluation of the occipital condyle and the hypoglossal canal was performed to avoid hypoglossal nerve injury during the screw placement. Thirteen recently frozen cadaveric specimens were used. The occipital condyle anatomy and the hypoglossal canal dimension were measured using reconstructed computed tomography images. Insertion torque and pullout strength were evaluated to compare the midline occipital keel screw, C0-C1 transarticular screw, C1 lateral mass screw, and direct occipital condyle screw. The dimensions of the occipital condyle allow use of a 3.5 or 4.0-mm diameter screw. Mean pullout strength was 1619.6 N for the midline occipital keel screw, 870.7 N for the C0-C1 transarticular screw, 707.0 N for the C1 lateral mass screw, and 431.7 N for the direct occipital condyle screw. Mean insertion torque was 0.55 Nm for the midline occipital keel screw, 0.32 Nm for the C0-C1 transarticular screw, 0.14 Nm for the C1 lateral mass screw, and 0.11 Nm for the direct occipital condyle screw. The condylar anatomy allows direct insertion of the occipital condyle screw and C0-C1 transarticular screw. These techniques are suitable options for the treatment of craniovertebral junction instabilities in selected patients.

• 2011-10-15

著者

• AN Howard

  Department of Orthopaedic Surgery

• An Howard

  Department Of Orthopedic Surgery Rush University Medical Center

• INOUE Nozomu

  Department of Orthopedic Surgery, Rush University Medical Center

• Inoue Nozomu

  Department Of Mechanical Engineering Faculty Of Engineering Doshisha University:department Of Orthop

• Inoue Nozomu

  Department Of Orthopedic Surgery Rush University Medical Center

• SUGISAKI Keizo

  Department of Orthopedic Surgery, Rush University Medical Center

• Hong Jae

  Department Of Neurosurgery Catholic University Of Korea St. Vincent's Hospital

• Sugisaki Keizo

  Department Of Orthopedic Surgery Rush University Medical Center

• TAKIGAWA Tomoyuki

  Department of Orthopedic Surgery, Kobe Red Cross Hospital

• ESPINOZA ORIAS

  Department of Orthopedic Surgery, Rush University Medical Center

• Takigawa Tomoyuki

  Department Of Orthopedic Surgery Kobe Red Cross Hospital

• Espinoza Orias

  Department Of Orthopedic Surgery Rush University Medical Center

• HONG Jae

  Department of Neurosurgery, Catholic University of Korea, St. Vincent's Hospital

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