The Spine Journal
Volume 9, Issue 12 , Pages 1016-1023 , December 2009

Screw angulation affects bone-screw stresses and bone graft load sharing in anterior cervical corpectomy fusion with a rigid screw-plate construct: a finite element model study

  • Mozammil Hussain, PhD

      Affiliations

    • Division of Research, Logan University, Chesterfield, MO 63017, USA
    • ,
  • Raghu N. Natarajan, PhD

      Affiliations

    • Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
    • Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
    • Corresponding Author InformationCorresponding author. Department of Orthopedic Surgery, Rush University Medical Center, 1653 West Congress Parkway, Suite 764A Armour Academic Facility, Chicago, IL 60612, USA. Tel.: (312) 942-5367; fax: (312) 942-2101.
    • ,
  • Amir H. Fayyazi, MD

      Affiliations

    • Department of Orthopaedics and Rehabilitation, Penn State College of Medicine, Allentown, PA 18103, USA
    • ,
  • Brian R. Braaksma, MD

      Affiliations

    • Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
    • ,
  • Gunnar B.J. Andersson, MD, PhD

      Affiliations

    • Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
    • ,
  • Howard S. An, MD

      Affiliations

    • Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA

Received 24 March 2009 ,Revised 14 July 2009 ,Accepted 29 August 2009.

References 

  1. Fernyhough JC, White JI, LaRocca H. Fusion rates in multilevel cervical spondylosis comparing allograft fibula with autograft fibula in 126 patients. Spine. 1991;16:S561–S564
  2. Yonenobu K, Fuji T, Ono K, et al. Choice of surgical treatment for multisegmental cervical spondylotic myelopathy. Spine. 1985;10:710–716
  3. Ikenaga M, Shikata J, Tanaka C. Anterior corpectomy and fusion with fibular strut grafts for multilevel cervical myelopathy. J Neurosurg Spine. 2005;3:79–85
  4. Thongtrangan I, Balabhadra R, Kim D. Management of strut graft failure in anterior cervical spine surgery. Neurosurg Focus. 2003;15:E4
  5. Lowery G, McDonough R. The significance of hardware failure in anterior cervical plate fixation. Patients with 2- to 7-year follow-up. Spine. 1998;23:181–186
  6. Panjabi MM, Isomi T, Wang JL. Loosening at the screw-vertebra junction in multilevel anterior cervical plate constructs. Spine. 1999;24:2383–2388
  7. Vaccaro AR, Falatyn SP, Scuderi GJ, et al. Early failure of long segment anterior cervical plate fixation. J Spinal Disord. 1998;11:410–415
  8. Rapoff A, Conrad B, Johnson W, et al. Load sharing in Premier and Zephir anterior cervical plates. Spine. 2003;28:2648–2650
  9. Grubb M, Currier B, Shih J, et al. Biomechanical evaluation of anterior cervical spine stabilization. Spine. 1998;23:886–892
  10. Spivak JM, Chen D, Kummer FJ. The effect of locking fixation screws on the stability of anterior cervical plating. Spine. 1999;24:334–338
  11. Delamarter R, Hyun W. Adjacent level degeneration secondary to dynamic cervical plating. 31st Annual Meeting of Cervical Spine Research Society, Scottsdale, AZ, Dec 11–13, 2003. Poster 14.
  12. Eck JC, Humphreys SC, Lim TH, et al. Biomechanical study on the effect of cervical spine fusion on adjacent-level intradiscal pressure and segmental motion. Spine. 2002;27:2431–2434
  13. Epstein N. Anterior cervical dynamic ABC plating with single level corpectomy and fusion in forty-two patients. Spinal Cord. 2003;41:153–158
  14. Delamarter R, Hyun W. Dynamic anterior cervical plates and why they fail? 71st Annual Meeting of American Academy of Orthopaedic Surgeons, San Francisco, CA, March 10–14, 2004. Poster 412.
  15. Stulik J, Pitzen T, Chrobok J, et al. Fusion and failure following anterior cervical plating with dynamic or rigid plates: 6-months results of a multi-centric, prospective, randomized, controlled study. Eur Spine J. 2007;16:1689–1694
  16. Dunn H. Spinal instrumentation. Part I. Principles of posterior and anterior instrumentation. Instr Course Lect. 1983;32:192–202
  17. Horton WC, Blackstock SF, Norman JT, et al. Strength of fixation of anterior vertebral body screws. Spine. 1996;21:439–444
  18. Samartzis D, Shen F, Matthews D, et al. Comparison of allograft to autograft in multilevel anterior cervical discectomy and fusion with rigid plate fixation. Spine. 2003;3:451–459
  19. Panjabi MM, Oxland TR, Parks EH. Quantitative anatomy of cervical spine ligaments. Part II. Middle and lower cervical spine. J Spinal Disord. 1991;4:277–285
  20. Yoganandan N, Kumaresan S, Pintar FA. Geometric and mechanical properties of human cervical spine ligaments. J Biomech Eng. 2000;122:623–629
  21. Mercer S, Bogduk N. The ligaments and annulus fibrosus of human adult cervical intervertebral discs. Spine. 1999;24:619–626
  22. Closkey R, Parsons J, Lee C, et al. Mechanics of interbody spinal fusion. Analysis of critical bone graft area. Spine. 1993;18:1011–1015
  23. Argoubi M, Shirazi-Adl A. Poroelastic creep response analysis of a lumbar motion segment in compression. J Biomech. 1996;29:1331–1339
  24. Lee C, Kim Y, Lee C, et al. Impact response of the intervertebral disc in a finite-element model. Spine. 2000;25:2431–2439
  25. Teo EC, Ng HW. Evaluation of the role of ligaments, facets and disc nucleus in lower cervical spine under compression and sagittal moments using finite element method. Med Eng Phys. 2001;23:155–164
  26. Kumaresan S, Yoganandan N, Pintar FA. Finite element modeling approaches of human cervical spine facet joint capsule. J Biomech. 1998;31:371–376
  27. Goel VK, Clausen JD. Prediction of load sharing among spinal components of a C5-C6 motion segment using the finite element approach. Spine. 1998;23:684–691
  28. Natarajan RN, Chen BH, An HS, Andersson GB. Anterior cervical fusion: a finite element model study on motion segment stability including the effect of osteoporosis. Spine. 2000;25:955–961
  29. Rohlmann A, Zander T, Bergmann G. Effects of fusion-bone stiffness on the mechanical behavior of the lumbar spine after vertebral body replacement. Clin Biomech. 2006;21:221–227
  30. Zander T, Rohlmann A, Klockner C, Bergmann G. Effect of bone graft characteristics on the mechanical behavior of the lumbar spine. J Biomech. 2002;35:491–497
  31. Ratner B, Hoffman A, Schoen F, Lemons J. Biomaterial science—an introduction to materials in medicine. San Diego, California: Academic Press; 1996;
  32. Clausen JD, Goel VK, Traynelis VC, et al. Uncinate processes and Luschka joints influence the biomechanics of the cervical spine: quantification using a finite element model of the C5-C6 segment. J Orthop Res. 1997;15:342–347
  33. Patwardhan A, Havey R, Ghanayem A, et al. Load-carrying capacity of the human cervical spine in compression is increased under a follower load. Spine. 2000;25:1548–1554
  34. Panjabi MM, Crisco JJ, Vasavada A, et al. Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves. Spine. 2001;26:2692–2700
  35. Wheeldon JA, Pintar FA, Knowles S, et al. Experimental flexion/extension data corridors for validation of finite element models of the young, normal cervical spine. J Biomech. 2006;39:375–380
  36. Dvorak J, Froehlich D, Penning L, et al. Functional radiographic diagnosis of the cervical spine: flexion/extension. Spine. 1988;13:748–755
  37. Dvorak J, Panjabi M, Novotny J, et al. In vivo flexion/extension of the normal cervical spine. J Orthop Res. 1991;9:828–834
  38. Dvorak J, Panjabi M, Grob D, et al. Clinical validation of functional flexion/extension radiographs of the cervical spine. Spine. 1993;18:120–127
  39. Holmes A, Wang C, Han ZH, Dang GT. The range and nature of flexion-extension motion in the cervical spine. Spine. 1994;19:2505–2510
  40. Lind B, Sihlbom H, Nordwall A, Malchau H. Normal range of motion of the cervical spine. Arch Phys Med Rehabil. 1989;70:692–695
  41. Penning L. Normal movements of the cervical spine. Am J Roent. 1978;130:317–326
  42. Iai H, Moriya H, Goto S, et al. Three-dimensional motion analysis of the upper cervical spine during axial rotation. Spine. 1993;18:2388–2392
  43. Mimura M, Moriya H, Watanabe T, et al. Three-dimensional motion analysis of the cervical spine with special reference to the axial rotation. Spine. 1989;14:1135–1139
  44. Penning L, Wilmink JT. Rotation of the cervical spine. A CT study in normal subjects. Spine. 1987;12:732–738
  45. Ishii T, Mukai Y, Hosono N, et al. Kinematics of the cervical spine in lateral bending: in vivo three-dimensional analysis. Spine. 2006;31:155–160
  46. Cagli S, Chamberlain RH, Sonntag VK, Crawford NR. The biomechanical effects of cervical multilevel oblique corpectomy. Spine. 2004;29:1420–1427
  47. Do Koh Y, Lim TH, Won You J, Eck J. A biomechanical comparison of modern anterior and posterior plate fixation of the cervical spine. Spine. 2001;26:15–21
  48. Samartz D, Marco R, Jenis L, et al. Characterization of graft subsidence in anterior cervical discectomy and fusion with rigid anterior plate fixation. Am J Orthop. 2007;36:421–428
  49. Rapoff A, O'Brien T, Ghanayem A, et al. Anterior cervical graft and plate load sharing. J Spinal Disord. 1999;12:45–49
  50. Kaiser M, Haid R, Subach B, et al. Anterior cervical plating enhances arthrodesis after discectomy and fusion with cortical allograft. Neurosurgery. 2002;50:229–236
  51. Sasso RC, Ruggiero RA, Reilly TM, Hall PV. Early reconstruction failures after multilevel cervical corpectomy. Spine. 2003;28:140–142
  52. Casha S, Fehlings MG. Clinical and radiological evaluation of the Codman semiconstrained load-sharing anterior cervical plate: prospective multicenter trial and independent blinded evaluation of outcome. J Neurosurg. 2003;99:264–270
  53. DiAngelo D, Foley K, Vossel K, et al. Anterior cervical plating reverses load transfer through multilevel strut-grafts. Spine. 2000;25:783–795
  54. Foley K, DiAngelo D, Rampersaud Y, et al. The in vitro effects of instrumentation on multilevel cervical strut-graft mechanics. Spine. 1999;24:2366–2376

 FDA device/drug status: not applicable.

 Author disclosures: BRB (royalties, U&I Inc.; stock ownership, board of directors, Articular Engineering LLC; consulting, fellowship support, Depuy Spine Inc.; speaking/teaching arrangements, endowments, Rush University Medical Center; scientific advisory board, Pioneer Inc.; grants, Depuy Spine Inc., NIH; fellowship support, Medtronic Inc.); HSN (consulting, Life Spine; speaking/teaching arrangement, Applied Spine).

PII: S1529-9430(09)00849-3

doi: 10.1016/j.spinee.2009.08.461

The Spine Journal
Volume 9, Issue 12 , Pages 1016-1023 , December 2009

Article Tools

* Image Usage & Resolution