Biomechanical assessment of anchored cervical interbody cages: Comparison of 2-screw and 4-screw designs

Document Type

Article

Abstract

Copyright © 2014 by the Congress of Neurological Surgeons. Background: A new anchored cervical interbody polyetheretherketone spacer was devised that uses only 2 integrated variable-angle screws diagonally into the adjacent vertebral bodies instead of the established device that uses 4 diagonal fixed-angle screws. Objective: To compare in vitro the stability provided by the new 2-screw interbody spacer with that of the 4-screw spacer and a 4-screw anterior plate plus independent polyetheretherketone spacer. Methods: Three groups of cadaveric specimens were tested with 2-screw anchored cage (n = 8), 4-screw anchored cage (n = 8), and standard plate/cage (n = 16). Pure moments (1.5 Nm) were applied to induce flexion, extension, lateral bending, and axial rotation while measuring 3-D motion optoelectronically. Results: In all 3 groups, the mean range of motion (ROM) and lax zone were significantly reduced relative to the intact spine after discectomy and fixation. The 2-screw anchored cage allowed significantly greater ROM (P <.05) than the standard plate during flexion, extension, and axial rotation and allowed significantly greater ROM than the 4-screw cage during extension and axial rotation. The 4-screw anchored cage did not allow significantly different ROM or lax zone than the standard plate during any loading mode. Conclusion: The 2-screw variable-angle anchored cage significantly reduces ROM relative to the intact spine. Greater stability can be achieved, especially during extension and axial rotation, by using the 4-screw cage or standard plate plus cage.

Keywords

Anterior plate, Biomechanics, Cervical spine, Discectomy, Interbody cage

Publication Date

1-1-1982

Publication Title

Neurosurgery

ISSN

0148396X

E-ISSN

15244040

Volume

10

First Page

412

Last Page

417

PubMed ID

24662505

Digital Object Identifier (DOI)

10.1227/NEU.0000000000000351

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