Biomechanical stability of multi-level inter-body cervical strut-graft fusion with posterior plating instrumentation

摘要

Strut-graft fusion with supplemental instrumentation is an accepted surgical treatment for multi-level cervical disease. There are many surgical methods for decompressing and reconstructing the cervical spine, e.g., anterior: multi-level discectomy, multi-level linter-body strut-graft fusion (SG), multi-level strut-graft with anterior plate instrumentation, or posterior: multi-level laminectomy with posterior lateral mass plating instrumentation. A relatively new surgical approach that combines these mthods is multi-level strut-graft fusion with positerior plating instrumentation (SGPP). Although the surgery should restore the moechanical integrity of the operated spine, little is known of the load-sharing mechanics between the SG and posterior instrumentation. Clinically, strut-grafted constructs fail by pistoning of the SG into the adjacent vertebrae, dislodgement of the SG at the vertebral interfaces. SG fracture, hardware breakage, or screw-plate extrusion. The ojbective of the study was to determine the biomechanical stability of SGPP spinal constructs and to study the influence of posterior plates on struct-graft loading mechanics in vitro.