title: Cervical spine locking plate: in vitro biomechanical testing.
abstract: The AO cervical spine locking plate (CSLP) for anterior subaxial fixation was recently received increasing clinical acclaim, yet to date the in vitro mechanical properties of this implant have not been reported. To determine the in vitro biomechanical properties of this device, five fresh human cadaver cervical spines were subjected to nondestructive testing in flexion and torsion in three stages: stage 1: intact spine; stage 2: destabilized spine; stage 3: destabilized spine with CSLP. Stage 3 specimens were also subjected to large angular displacement testing to assess the integrity of the fixation. In flexion, mean spinous process displacement was 1.21 mm for stage 1, 3.19 mm for stage 2, and 1.37 mm, for stage 3. Mean torsional stiffness was 2.86 Nm/degree in stage 1, 1.82Nm/degree in stage 2, and 2.20Nm/degree in stage 3. Large angular displacement testing in stage 3 resulted in screw loosening from the bone in two specimens; no screw plate loosening occurred. In our severely destabilized in vitro model, the CSLP restored flexion stability but not rotational stability. This suggests that supplemented bracing or fixation may be required to restore torsional stability.
authors.affiliation: Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Smith
authors.forename: R W
authors.initials: RW
authors.lastname: Lindsey
authors.forename: B J
authors.initials: BJ
authors.lastname: Doherty
authors.forename: J W
authors.initials: JW
authors.lastname: Alexander
authors.forename: J H
authors.initials: JH
authors.lastname: Dickson
mesh_terms: D001696:Biomechanical Phenomena; D015519:Bone Density; D001860:Bone Plates; D002574:Cervical Vertebrae / Q000601:surgery*; D004867:Equipment Design; D006801:Humans; D066298:In Vitro Techniques; D007593:Joint Instability / Q000601:surgery; D008422:Materials Testing; D016059:Range of Motion, Articular; D013131:Spine / Q000601:surgery*; D013718:Tensile Strength