Your browser doesn't support javascript.
loading
A biomechanical comparison of a cement-augmented odontoid screw with a posterior-instrumented fusion in geriatric patients with an odontoid fracture type IIb.
Schwarz, Falko; Liebsch, Christian; Berger-Roscher, Nikolaus; Wilke, Hans-Joachim; Sakr, Yasser; Kalff, Rolf; Waschke, Albrecht.
Afiliação
  • Schwarz F; Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
  • Liebsch C; Trauma Research Centre Ulm, Institute of Orthopaedic Research and Biomechanics, Ulm University, Ulm, Germany.
  • Berger-Roscher N; Trauma Research Centre Ulm, Institute of Orthopaedic Research and Biomechanics, Ulm University, Ulm, Germany.
  • Wilke HJ; Trauma Research Centre Ulm, Institute of Orthopaedic Research and Biomechanics, Ulm University, Ulm, Germany. hans-joachim.wilke@uni-ulm.de.
  • Sakr Y; Department of Anaesthesiology and Intensive Care, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
  • Kalff R; Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
  • Waschke A; Department of Neurosurgery, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany.
Eur Spine J ; 30(6): 1566-1573, 2021 06.
Article em En | MEDLINE | ID: mdl-33929612
PURPOSE: Possible surgical therapies for odontoid fracture type IIb include odontoid screw osteosynthesis (OG) with preservation of mobility or dorsal C1/2 fusion with restriction of cervical rotation. In order to reduce material loosening in odontoid screw osteosynthesis in patients with low bone density, augmentation at the base of the axis using bone cement has been established as a suitable alternative. In this study, we compared cement-augmented OG and C1/2 fusion according to Harms (HG). METHODS: Body donor preparations of the 1st and 2nd cervical vertebrae were randomized in 2 groups (OG vs. HG). The range of motion (ROM) was determined in 3 principle motion plains. Subsequently, a cyclic loading test was performed. The decrease in height of the specimen and the double amplitude height were determined as absolute values as an indication of screw loosening. Afterward, the ROM was determined again and loosening of the screws was measured in a computed tomography. RESULTS: A total of 16 were included. Two groups of 8 specimens (OG vs. HG) from patients with a median age of 80 (interquartile range (IQ) 73.5-85) years and a reduced bone density of 87.2 (IQ 71.2-104.5) mg/cc dipotassium hydrogen phosphate were examined for their biomechanical properties. Before and after exposure, the OG preparations were significantly more mobile. At the time of loading, the OG had similar loading properties to HG decrease in height of the specimen and the double amplitude height. Computed tomography revealed similar outcomes with regard to the screw loosening rate (62.5 vs. 87.5%, p = 0.586). CONCLUSION: In patients with an odontoid fracture type IIb and reduced bone density, cement-augmented odontoid screw yielded similar properties in the loading tests compared to the HG. It may, therefore, be considered as a primary alternative to preserve cervical mobility in these patients.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fraturas da Coluna Vertebral / Processo Odontoide Tipo de estudo: Clinical_trials Limite: Aged / Aged80 / Humans Idioma: En Revista: Eur Spine J Assunto da revista: ORTOPEDIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Alemanha País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fraturas da Coluna Vertebral / Processo Odontoide Tipo de estudo: Clinical_trials Limite: Aged / Aged80 / Humans Idioma: En Revista: Eur Spine J Assunto da revista: ORTOPEDIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Alemanha País de publicação: Alemanha