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Biomechanical comparison of anterior axis-atlanto-occipital transarticular fixation and anterior atlantoaxial transarticular fixation after odontoidectomy: A finite element analysis

Background: Anterior axis-atlanto-occipital transarticular fixation (AAOF) and anterior atlanto-axial transarticular fixation (AAF) are two common anterior screw fixation techniques after odontoidectomy, but the biomechanical discrepancies between them remain unknown. Objectives: To investigate the...

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Autores principales: Lu, Yuzhao, Hang, Gai, Feng, Yu, Chen, Bo, Ma, Shenghui, Wang, Yang, Xie, Tianhao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027935/
https://www.ncbi.nlm.nih.gov/pubmed/36959905
http://dx.doi.org/10.3389/fbioe.2023.1067049
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author Lu, Yuzhao
Hang, Gai
Feng, Yu
Chen, Bo
Ma, Shenghui
Wang, Yang
Xie, Tianhao
author_facet Lu, Yuzhao
Hang, Gai
Feng, Yu
Chen, Bo
Ma, Shenghui
Wang, Yang
Xie, Tianhao
author_sort Lu, Yuzhao
collection PubMed
description Background: Anterior axis-atlanto-occipital transarticular fixation (AAOF) and anterior atlanto-axial transarticular fixation (AAF) are two common anterior screw fixation techniques after odontoidectomy, but the biomechanical discrepancies between them remain unknown. Objectives: To investigate the biomechanical properties of craniovertebral junction (CVJ) after odontoidectomy, with AAOF or AAF. Methods: A validated finite element model of the intact occipital-cervical spine (from occiput to T1) was modified to investigate biomechanical changes, resulting from odontoidectomy, odontoidectomy with AAOF, and odontoidectomy with AAF. Results: After odontoidectomy, the range of motion (ROM) at C1-C2 increased in all loading directions, and the ROM at the Occiput-C1 elevated by 66.2%, 57.5%, and 41.7% in extension, lateral bending, and torsion, respectively. For fixation models, the ROM at the C1-C2 junction was observably reduced after odontoidectomy with AAOF and odontoidectomy with AAF. In addition, at the Occiput-C1, the ROM of odontoidectomy with AAOF model was notably lower than the normal model in extension (94.9%), flexion (97.6%), lateral bending (91.8%), and torsion (96.4%). But compared with the normal model, in the odontoidectomy with AAF model, the ROM of the Occiput-C1 increased by 52.2%, −0.1%, 92.1%, and 34.2% in extension, lateral bending, and torsion, respectively. Moreover, there were no distinctive differences in the stress at the screw-bone interface or the C2-C3 intervertebral disc between the two fixation systems. Conclusion: AAOF can maintain CVJ stability at the Occiput-C1 after odontoidectomy, but AAF cannot. Thus, for patients with pre-existing atlanto-occipital joint instability, AAOF is more suitable than AAF in the choice of anterior fixation techniques.
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spelling pubmed-100279352023-03-22 Biomechanical comparison of anterior axis-atlanto-occipital transarticular fixation and anterior atlantoaxial transarticular fixation after odontoidectomy: A finite element analysis Lu, Yuzhao Hang, Gai Feng, Yu Chen, Bo Ma, Shenghui Wang, Yang Xie, Tianhao Front Bioeng Biotechnol Bioengineering and Biotechnology Background: Anterior axis-atlanto-occipital transarticular fixation (AAOF) and anterior atlanto-axial transarticular fixation (AAF) are two common anterior screw fixation techniques after odontoidectomy, but the biomechanical discrepancies between them remain unknown. Objectives: To investigate the biomechanical properties of craniovertebral junction (CVJ) after odontoidectomy, with AAOF or AAF. Methods: A validated finite element model of the intact occipital-cervical spine (from occiput to T1) was modified to investigate biomechanical changes, resulting from odontoidectomy, odontoidectomy with AAOF, and odontoidectomy with AAF. Results: After odontoidectomy, the range of motion (ROM) at C1-C2 increased in all loading directions, and the ROM at the Occiput-C1 elevated by 66.2%, 57.5%, and 41.7% in extension, lateral bending, and torsion, respectively. For fixation models, the ROM at the C1-C2 junction was observably reduced after odontoidectomy with AAOF and odontoidectomy with AAF. In addition, at the Occiput-C1, the ROM of odontoidectomy with AAOF model was notably lower than the normal model in extension (94.9%), flexion (97.6%), lateral bending (91.8%), and torsion (96.4%). But compared with the normal model, in the odontoidectomy with AAF model, the ROM of the Occiput-C1 increased by 52.2%, −0.1%, 92.1%, and 34.2% in extension, lateral bending, and torsion, respectively. Moreover, there were no distinctive differences in the stress at the screw-bone interface or the C2-C3 intervertebral disc between the two fixation systems. Conclusion: AAOF can maintain CVJ stability at the Occiput-C1 after odontoidectomy, but AAF cannot. Thus, for patients with pre-existing atlanto-occipital joint instability, AAOF is more suitable than AAF in the choice of anterior fixation techniques. Frontiers Media S.A. 2023-03-07 /pmc/articles/PMC10027935/ /pubmed/36959905 http://dx.doi.org/10.3389/fbioe.2023.1067049 Text en Copyright © 2023 Lu, Hang, Feng, Chen, Ma, Wang and Xie. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Lu, Yuzhao
Hang, Gai
Feng, Yu
Chen, Bo
Ma, Shenghui
Wang, Yang
Xie, Tianhao
Biomechanical comparison of anterior axis-atlanto-occipital transarticular fixation and anterior atlantoaxial transarticular fixation after odontoidectomy: A finite element analysis
title Biomechanical comparison of anterior axis-atlanto-occipital transarticular fixation and anterior atlantoaxial transarticular fixation after odontoidectomy: A finite element analysis
title_full Biomechanical comparison of anterior axis-atlanto-occipital transarticular fixation and anterior atlantoaxial transarticular fixation after odontoidectomy: A finite element analysis
title_fullStr Biomechanical comparison of anterior axis-atlanto-occipital transarticular fixation and anterior atlantoaxial transarticular fixation after odontoidectomy: A finite element analysis
title_full_unstemmed Biomechanical comparison of anterior axis-atlanto-occipital transarticular fixation and anterior atlantoaxial transarticular fixation after odontoidectomy: A finite element analysis
title_short Biomechanical comparison of anterior axis-atlanto-occipital transarticular fixation and anterior atlantoaxial transarticular fixation after odontoidectomy: A finite element analysis
title_sort biomechanical comparison of anterior axis-atlanto-occipital transarticular fixation and anterior atlantoaxial transarticular fixation after odontoidectomy: a finite element analysis
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027935/
https://www.ncbi.nlm.nih.gov/pubmed/36959905
http://dx.doi.org/10.3389/fbioe.2023.1067049
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