Unilateral cervical facet dislocation: biomechanics of fixation.
METHODS
Unilateral facet dislocation was created in human cadaveric cervical spines. Specimens were sequentially instrumented with posterior or anterior screws and plates, and studied biomechanically.


OBJECTIVE
To determine the biomechanical differences between anterior and posterior fixation for stabilization of a reduced unilateral cervical facet dislocation.


BACKGROUND
Although previous studies have compared anterior to posterior instrumentation, no data exist on the biomechanics of either type of stabilization after this particular injury.


METHODS
In 6 human cadaveric cervical spine segments, a reproducible unilateral facet dislocation was created and then unlocked (reduced). Nondestructive torques were applied to specimens that were intact, injured-reduced, fixated using posterior nonlocking lateral mass plates, and fixated using a bone graft plus an anterior nonlocking plate. Flexion, extension, lateral bending, and axial rotation were measured stereophotogrammetrically.


RESULTS
Lateral mass plating was more effective than anterior plating in limiting motion after reduction of a unilateral facet dislocation. Averaged, over all loading directions, lateral mass plates reduced the range of motion to 17% of normal; anterior plates reduced range of motion to 89% of normal. In all loading directions, lateral mass plates performed significantly better than anterior plates (P < 0.05, paired Student t-tests).


CONCLUSIONS
Anterior and posterior plating effectively stabilized a reduced unilateral facet dislocation. Lateral mass fixation provided better immobilization than anterior graft and plate.
Duggal
Neil
N
London Health Sciences Centre London, Ontario, Canada.
Chamberlain
Robert H
RH
Park
Sung Chan
SC
Sonntag
Volker K H
VK
Dickman
Curtis A
CA
Crawford
Neil R
NR
D000328:Adult; D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D002102:Cadaver; D005260:Female; D006801:Humans; D007103:Immobilization; D016268:Internal Fixators; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D013131:Spine / Q000503:physiopathology* / Q000601:surgery*; D019415:Torque