Biomechanical investigation of intra-articular cage and cantilever technique in the treatment of congenital basilar invagination combined with atlantoaxial dislocation: a finite element analysis
Biomechanical effect of posterior intra-articular cages and cantilever technique on the congenital basilar invagination (BI) combined with atlantoaxial dislocation (AAD) was investigated and evaluated using finite element (FE) analysis. A 3D nonlinear occipitocervical segment C0-C3 FE models of congenital BI and AAD was established. Then, the FE model treated with C2 pedicle screw and occipital plate fixation coupled with intra-articular cages (Cage+ C2PS + OP) was compared to that without intra-articular cages (C2PS +OP). The range of motion (ROM) of COC1-C2 and the maximum von Mises stresses (MVMS) on the intra-articular cages, screw-plate system, and C2 endplate were calculated and compared to further analyze the stability of atlantoaxial joint and assess the collapse and fracture risks of intra-articular cages and screw-plate system. ROM of COC1-C2 segment was reduced by 57.58%, 63.33%, 78.18%, and 75.90%, and the peak stresses of C2 pedicle screw and occipital plate were decreased by 84.86%, 72.90%, 73.24%, and 84.90% and 78.35%, 76.64%, 81.82%, and 89.49% for Cage + C2PS +OP model in flexion, extension, lateral bending, and axial rotation when compared with the C2PS +OP model under the same condition. The MVMS of intra-articular cages were 13.80 MPa, 40.26 MPa, 26.93 MPa, and 17.50 MPa and those of C2 endplate were 14.56 MPa, 34.80 MPa, 36.29 MPa, and 37.56 MPa in Cage +C2PS +OP model under same conditions. Posterior intra-articular cages and cantilever technique to treat BI-AAD can improve the stability of the atlantoaxial joint and reduce the risk of screw-plate breakage. The intra-articular cages can not only complement the height loss on account of atlantooccipital fusion but also provide stable support for posterior fixation fusion.
基金:
National Natural Science Foundation of China [11502146]; Shanghai Natural Science Foundation [15ZR1429600]; Beijing Hospitals Authority Clinical medicine Development of Special Funding [XMLX202138]
第一作者机构:[1]Univ Shanghai Sci & Technol, Sch Hlth Sci & Engn, Shanghai, Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
Zhao Gaiping,Song Mei,Duan Wanru,et al.Biomechanical investigation of intra-articular cage and cantilever technique in the treatment of congenital basilar invagination combined with atlantoaxial dislocation: a finite element analysis[J].MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING.2022,60(8):2189-2199.doi:10.1007/s11517-022-02596-y.
APA:
Zhao, Gaiping,Song, Mei,Duan, Wanru,Chen, Zan&Xue, Yaru.(2022).Biomechanical investigation of intra-articular cage and cantilever technique in the treatment of congenital basilar invagination combined with atlantoaxial dislocation: a finite element analysis.MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING,60,(8)
MLA:
Zhao, Gaiping,et al."Biomechanical investigation of intra-articular cage and cantilever technique in the treatment of congenital basilar invagination combined with atlantoaxial dislocation: a finite element analysis".MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING 60..8(2022):2189-2199