Top

European Spine Journal

Published in:

01-05-2019 | Original Article

Preclinical evaluation of a novel anterior non-fusion fixation device for atlantoaxial instability: an in vivo comparison study in a canine model

Authors: Xuan Cai, Xiaoqing Yi, Haopeng Li, Xijing He

Published in: European Spine Journal | Issue 5/2019

Abstract

Purpose

The Anterior Atlantoaxial Non-Fusion Fixation System (AANFS) was a novel motion preservation device for atlantoaxial instability to replace traditional fusion techniques. The purpose of this in vivo study was to evaluate the clinical features and biomechanical properties of this new device in a canine model by comparing it with a conventional method.

Methods

Eighteen adult male canines were randomly divided into group 1, which received the AANFS replacement, group 2 which received the Harms rigid fixation procedures, and group 3, which served as the control group. Routine follow-up evaluations were performed postoperatively. Specimens were harvested 12 weeks after the operation. Biomechanical tests were conducted to obtain the range of motion (ROM) and neutral zone (NZ) at C1–C2 segment in different groups.

Results

The canines successfully tolerated the entire experimental procedure. No significant differences were found in surgery time, blood loss and recovery time between the AANFS group and the Harms rigid fixation group. Radiological examinations revealed that the position of the implant was good. Biomechanical results showed that, compared with the intact group, the mean ROM and NZ in flexion, extension, lateral bending and rotation were significantly reduced after rigid fixation. However, after the AANFS implantation, ROM and NZ in all directions were similar to those of the intact state.

Conclusions

This study for the first time provides an animal model for studying non-fusion strategies of upper cervical spine. The AANFS was able to maintain movement function of the atlantoaxial joint and may be an alternative to traditional fusion techniques.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

Available only for authorised users

Nakagawa H, Yagi K (2014) Advancement in atlantoaxial fixation. World Neurosurg 82:e143–e144CrossRefPubMed

Dickman CA, Crawford NR, Brantley AG, Sonntag VK (1995) Biomechanical effects of transoral odontoidectomy. Neurosurgery 36:1146–1152CrossRefPubMed

Elliott RE, Tanweer O, Boah A, Morsi A, Ma T, Frempong-Boadu A et al (2014) Outcome comparison of atlantoaxial fusion with transarticular screws and screw-rod constructs: meta-analysis and review of literature. J Spinal Disord Tech 27:11–28CrossRefPubMed

Du JY, Aichmair A, Kueper J, Wright T, Lebl DR (2015) Biomechanical analysis of screw constructs for atlantoaxial fixation in cadavers: a systematic review and meta-analysis. J Neurosurg Spine 22:151–161CrossRefPubMed

Rajinda P, Towiwat S, Chirappapha P (2017) Comparison of outcomes after atlantoaxial fusion with C1 lateral mass-C2 pedicle screws and C1–C2 transarticular screws. Eur Spine J 26:1064–1072CrossRefPubMed

Elbadrawi AM, Elkhateeb TM (2017) Transoral approach for odontoidectomy efficacy and safety. HSS J 13:276–281CrossRefPubMed

Shriver MF, Kshettry VR, Sindwani R, Woodard T, Benzel EC, Recinos PF (2016) Transoral and transnasal odontoidectomy complications: a systematic review and meta-analysis. Clin Neurol Neurosurg 148:121–129CrossRefPubMed

Derman PB, Lampe LP, Lyman S, Kueper J, Pan TJ, Girardi FP et al (2016) Atlantoaxial fusion: sixteen years of epidemiology, indications, and complications in New York State. Spine (Phila Pa 1976) 41:1586–1592CrossRef

Cai X, He X, Li H, Wang D (2013) Total atlanto-odontoid joint arthroplasty system: a novel motion preservation device for atlantoaxial instability after odontoidectomy. Spine (Phila Pa 1976) 38:451–457CrossRef

10.

Lu B, He X, Zhao CG, Li HP, Wang D (2009) Biomechanical study of artificial atlanto-odontoid joint. Spine (Phila Pa 1976) 34:1893–1899CrossRef

11.

Goel A, Desai KI, Muzumdar DP (2002) Atlantoaxial fixation using plate and screw method: a report of 160 treated patients. Neurosurgery 51:1351–1356CrossRefPubMed

12.

Tanenbaum JE, Lubelski D, Rosenbaum BP, Thompson NR, Benzel EC, Mroz TE (2016) Predictors of outcomes and hospital charges following atlantoaxial fusion. Spine J 16:608–618CrossRefPubMedPubMedCentral

13.

Skeppholm M, Lindgren L, Henriques T, Vavruch L, Löfgren H, Olerud C (2015) The Discover artificial disc replacement versus fusion in cervical radiculopathy—a randomized controlled outcome trial with 2-year follow-up. Spine J 15:1284–1294CrossRefPubMed

14.

Goel A (2015) Artificial atlantoaxial joint: is it a possible option? J Craniovertebr Junction Spine 6:147–148CrossRefPubMedPubMedCentral

15.

Moriguchi Y, Mojica-Santiago J, Grunert P, Pennicooke B, Berlin C, Khair T et al (2017) Total disc replacement using tissue-engineered intervertebral discs in the canine cervical spine. PLoS ONE 12:e0185716CrossRefPubMedPubMedCentral

16.

Grunert P, Moriguchi Y, Grossbard BP, Ricart Arbona RJ, Bonassar LJ, Härtl R (2017) Degenerative changes of the canine cervical spine after discectomy procedures, an in vivo study. BMC Vet Res 13:193CrossRefPubMedPubMedCentral

17.

Farrokhi MR, Torabinezhad S, Ghajar KA (2010) Pilot study of a new acrylic cage in a dog cervical spine fusion model. J Spinal Disord Tech 23:272–277CrossRefPubMed

18.

Johnson JA, da Costa RC, Bhattacharya S, Goel V, Allen MJ (2011) Kinematic motion patterns of the cranial and caudal canine cervical spine. Vet Surg 40:720–727CrossRefPubMed

19.

20.

Kim SM, Lim TJ, Paterno J, Hwang TJ, Lee KW, Balabhadra RS et al (2004) Biomechanical comparison of anterior and posterior stabilization methods in atlantoaxial instability. J Neurosurg 100(3 Suppl Spine):277–283PubMed

21.

Ohe M, Moridaira H, Inami S, Takeuchi D, Nohara Y, Taneichi H (2018) Pedicle screws with a thin hydroxyapatite coating for improving fixation at the bone-implant interface in the osteoporotic spine: experimental study in a porcine model. J Neurosurg Spine 28:679–687CrossRefPubMed

Title: Preclinical evaluation of a novel anterior non-fusion fixation device for atlantoaxial instability: an in vivo comparison study in a canine model
Authors: Xuan Cai
Xiaoqing Yi
Haopeng Li
Xijing He
Publication date: 01-05-2019
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 5/2019
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-019-05916-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Preclinical evaluation of a novel anterior non-fusion fixation device for atlantoaxial instability: an in vivo comparison study in a canine model

Abstract

Purpose

Methods

Results

Conclusions

Graphical abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Graphical abstract

Please log in to get access to this content

Other articles of this Issue 5/2019

Answer to the Letter to the Editor of Manu N. Capoor et al. concerning “Low virulence bacterial infections in cervical intervertebral discs: a prospective case series” by Chen Y, Wang X, Zhang X, et al. (Eur Spine J; 2018: doi: 10.1007/s00586-018-5582-4)

A pilot randomized controlled trial of 6-week combined exercise program on fasting insulin and fitness levels in individuals with spinal cord injury

Quantitative magnetic resonance imaging assessment of lateral atlantoaxial joint meniscoid composition: a validation study

Announcement

GEORG SCHMORL PRIZE OF THE GERMAN SPINE SOCIETY (DWG) 2018: combined inflammatory and mechanical stress weakens the annulus fibrosus: evidences from a loaded bovine AF organ culture

Letter to the Editor concerning “Is L5–S1 motion segment different from the rest? A radiographic kinematic assessment of 72 patients with chronic low back pain” by AB Sabnis et al. (Eur Spine J; 27(5):1127–1135)