• français
    • English
    français
  • Login
Help
View Item 
  •   Home
  • Institut de Biomécanique Humaine Georges Charpak (IBHGC)
  • View Item
  • Home
  • Institut de Biomécanique Humaine Georges Charpak (IBHGC)
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

Biomechanical cadaver study of proximal fixation in a minimally invasive bipolar construct

Article dans une revue avec comité de lecture
Author
GAUME, Mathilde
PERSOHN, Sylvain
GLORION, Christophe
414766 Hôpital Necker - Enfants Malades [AP-HP]
ccSKALLI, Wafa
MILADI, Lotfi
414766 Hôpital Necker - Enfants Malades [AP-HP]
ccVERGARI, Claudio
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]

URI
http://hdl.handle.net/10985/18377
DOI
10.1007/s43390-019-00014-2
Date
2020
Journal
Spine Deformity

Abstract

Study design Biomechanical human cadaver study. Objective To determine the three-dimensional intervertebral ranges of motion (ROMs) of intact and hook-instrumented tho- racic spine specimens subjected to physiological loads, using an in vitro experimental protocol with EOS biplane radiography. Summary of background data Pedicle screws are commonly used in thoracic instrumentation constructs, and their biome- chanical properties have been widely studied. Promising clinical results have been reported using a T1–T5 thoracic hook–claw construct for proximal rod anchoring. Instrumentation stability is a crucial factor in minimizing mechanical complications rates but had not been assessed for this construct in a biomechanical study. Methods Six fresh-frozen human cadaver C6–T7 thoracic spines were studied. The first thoracic vertebrae were instrumented using two claws of supra-laminar and pedicle hooks, each fixed on two adjacent vertebrae, on either side of a single free vertebra. Quasi-static pure-moment loads up to 5 Nm were applied to each specimen before and after instrumentation, in flexion–extension, right and left bending, and axial rotation. Five steel beads impacted in each vertebra allowed 3D tracking of vertebral movements on EOS biplanar radiographs acquired after each loading step. The relative ranges of motion (ROMs) of each pair of vertebras were computed. Results Mean ROMs with the intact specimens were 17° in flexion–extension, 27.9° in lateral bending, and 29.5° in axial rotation. Corresponding values with the instrumented specimens were 0.9°, 2.6°, and 7.3°, respectively. Instrumentation sig- nificantly (P < 0.05) decreased flexion–extension (by 92–98%), lateral bending (by 87–96%), and axial rotation (by 68–84%). Conclusion This study establishes the biomechanical stability of a double claw–hook construct in the upper thoracic spine, which may well explain the low mechanical complication rate in previous clinical studies. Level of evidence Not applicable, experimental cadaver study.

Files in this item

Name:
IBHGC_SD_2020_GAUME.pdf
Size:
975.4Kb
Format:
PDF
Description:
Article
Embargoed until:
2020-07-08
View/Open

Collections

  • Institut de Biomécanique Humaine Georges Charpak (IBHGC)

Related items

Showing items related by title, author, creator and subject.

  • From in vitro evaluation of a finite element model of the spine to in silico comparison of spine instrumentations 
    Article dans une revue avec comité de lecture
    ccVERGARI, Claudio; GAUME, Mathilde; PERSOHN, Sylvain; MILADI, Lotfi; ccSKALLI, Wafa (Elsevier, 2021)
    Growth-preserving spinal surgery suffer from high complications rate. A recent bipolar instrumentation using two anchoring points (thoracic and pelvic) showed lower rates, but its biomechanical behaviour has not been ...
  • Minimally Invasive Surgery for Neuromuscular Scoliosis: Results and Complications at a Minimal Follow-up of 5 Years 
    Article dans une revue avec comité de lecture
    GAUME, Mathilde; ccVERGARI, Claudio; KHOURI, Nejib; ccSKALLI, Wafa; GLORION, Christophe; MILADI, Lotfi (​​​​​​​​​​​​​​​​​​Lippincott Williams & Wilkins, 2021)
    Study Design. A prospective study. Objective. The aim of this study was to report the results of an alternative technique to growing rods (GR) for neuromuscular scoliosis using a minimally invasive fusionless surgery ...
  • Thigh and paraspinal muscles change after fusionless bipolar fixation for early onset scoliosis in type 2 spinal muscular atrophy 
    Article dans une revue avec comité de lecture
    GAUME, Mathilde; ccVERGARI, Claudio; ccCREZE, Maud; ccBONNET-LEBRUN, Aurore; ccMUTH-SENG, Christophe; ccQUIJANO-ROY, Susana; MILADI, Lotfi; ccSKALLI, Wafa; CARLIER, Robert-Yves (Elsevier BV, 2024-11)
    Background Spinal muscular atrophy is a severe, progressive autosomal recessive neuromuscular disorder associated with neuromuscular scoliosis. When bracing is not sufficient to control the deformity, early spinal surgery ...
  • Spontaneous induced bone fusion in minimally invasive fusionless bipolar fixation in neuromuscular scoliosis: a computed tomography analysis 
    Article dans une revue avec comité de lecture
    GAUME, Mathilde; LANGLAIS, Tristan; ccLOISELET, Klervie; PANNIER, S.; ccSKALLI, Wafa; ccVERGARI, Claudio; MILADI, Lotfi (Springer Science and Business Media LLC, 2023-05)
    Purpose Posterior spinal fusion (PSF) at skeletal maturity is still the gold standard in children with neuromuscular scoliosis (NMS) who underwent fusionless surgery. The aim of this computed tomography (CT) study was ...
  • Evidence of spinal stiffening following fusionless bipolar fixation for neuromuscular scoliosis: a shear wave elastography assessment of lumbar annulus fibrosus 
    Article dans une revue avec comité de lecture
    GAUME, Mathilde; ccLOISELET, Klervie; CHEKIR, Hedi; ccLANGLAIS, Tristan; ccBODDAERT, Nathalie; STRICKER, Sarah; PANNIER, Stéphanie; ccSKALLI, Wafa; MILADI, Lotfi; ccVERGARI, Claudio (Springer Science and Business Media LLC, 2023-11)
    Objectives There are no established criteria for stiffness after fusionless surgery for neuromuscular scoliosis (NMS). As a result, there is no consensus regarding the surgical strategy to propose at long-term follow-up. ...

Browse

All SAMCommunities & CollectionsAuthorsIssue DateCenter / InstitutionThis CollectionAuthorsIssue DateCenter / Institution

Newsletter

Latest newsletterPrevious newsletters

Statistics

Most Popular ItemsStatistics by CountryMost Popular Authors

ÉCOLE NATIONALE SUPERIEURE D'ARTS ET METIERS

  • Contact
  • Mentions légales

ÉCOLE NATIONALE SUPERIEURE D'ARTS ET METIERS

  • Contact
  • Mentions légales