A plate-rod device for treatment of cervicothoracic disorders: Comparison of mechanical testing with established cervical spine in vitro load testingdata
Ar. Vaccaro et al., A plate-rod device for treatment of cervicothoracic disorders: Comparison of mechanical testing with established cervical spine in vitro load testingdata, J SPINAL D, 13(4), 2000, pp. 350-355
Posterior cervical internal fixation has long been accomplished using wires
, hooks, and rods. More recently, the cervical lateral mass screw and plate
or rod systems have been used effectively in unstable lower cervical spine
disorders. Each form of fixation has its advantages and disadvantages. Int
erspinous wiring and lateral mass screw placement obviate canal penetration
in the cervical region but are associated with a potential neurologic risk
as a result of canal encroachment. Minor canal intrusion by laminar hooks
in the thoracic spine pose a lesser neurologic risk than in the cervical re
gion. To exploit the benefits and safety features of spinal instrumentation
, a combination plate rod construct (PRC) has been developed that obviates
canal penetration in the cervical region by way of lateral mass and cervica
l pedicle screw fixation and hooks or wires in the thoracic spine. A biomec
hanical analysis of the PRC device was performed and compared with the in v
ivo maximal load data of the cervical spine and established maximal load da
ta of the Roy-Camille posterior cervical fixation system. The PRC has great
er strength and resistance to failure than is necessary to sustain maximal
in vivo cervical spine loads, and it has also compared favorably with the p
arameters of the Roy-Camille system. The PRC device, or variations on it, i
s an excellent option for spinal fixation across the cervicothoracic juncti
on because of its superior biomechanical qualities and versatility in stabi
lizing a complex anatomic junction of the spine.