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Biomechanical investigation of intra-articular cage and cantilever technique in the treatment of congenital basilar invagination combined with atlantoaxial dislocation: a finite element analysis

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机构: [1]Univ Shanghai Sci & Technol, Sch Hlth Sci & Engn, Shanghai, Peoples R China [2]Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing, Peoples R China
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关键词: BI-AAD Intra-articular cage Screw-plate system Cl occipitalization Finite element analysis

摘要:
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.

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基金编号: 11502146 15ZR1429600 XMLX202138

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出版当年[2021]版:
大类 | 3 区 工程技术
小类 | 3 区 数学与计算生物学 4 区 计算机:跨学科应用 4 区 工程:生物医学 4 区 医学:信息
最新[2023]版:
大类 | 4 区 医学
小类 | 2 区 数学与计算生物学 4 区 计算机:跨学科应用 4 区 工程:生物医学 4 区 医学:信息
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出版当年[2020]版:
Q2 MATHEMATICAL & COMPUTATIONAL BIOLOGY Q3 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Q3 MEDICAL INFORMATICS Q3 ENGINEERING, BIOMEDICAL
最新[2023]版:
Q2 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Q2 MATHEMATICAL & COMPUTATIONAL BIOLOGY Q3 ENGINEERING, BIOMEDICAL Q3 MEDICAL INFORMATICS

影响因子: 最新[2023版] 最新五年平均 出版当年[2020版] 出版当年五年平均 出版前一年[2019版] 出版后一年[2021版]

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第一作者机构: [1]Univ Shanghai Sci & Technol, Sch Hlth Sci & Engn, Shanghai, Peoples R China
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