alexa Stability of the craniovertebral junction after unilateral occipital condyle resection: a biomechanical study.
Neurology

Neurology

Journal of Spine

Author(s): Vishteh AG, Crawford NR, Melton MS, Spetzler RF, Sonntag VK,

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Abstract OBJECT: The authors sought to determine the biomechanics of the occipitoatlantal (occiput [Oc]-C1) and atlantoaxial (C1-2) motion segments after unilateral gradient condylectomy. METHODS: Six human cadaveric specimens (skull with attached upper cervical spine) underwent nondestructive biomechanical testing (physiological loads) during flexion-extension, lateral bending, and axial rotation. Axial translation from tension to compression was also studied across Oc-C2. Each specimen served as its own control and underwent baseline testing in the intact state. The specimens were then tested after progressive unilateral condylectomy (25\% resection until completion), which was performed using frameless stereotactic guidance. At Oc-C1 for all motions that were tested, mobility increased significantly compared to baseline after a 50\% condylectomy. Flexion-extension, lateral bending, and axial rotation increased 15.3\%, 40.8\%, and 28.1\%, respectively. At C1-2, hypermobility during flexion-extension occurred after a 25\% condylectomy, during axial rotation after 75\% condylectomy, and during lateral bending after a 100\% condylectomy. CONCLUSIONS: Resection of 50\% or more of the occipital condyle produces statistically significant hypermobility at Oc-C1. After a 75\% resection, the biomechanics of the Oc-C1 and C1-2 motion segments change considerably. Performing fusion of the craniovertebral junction should therefore be considered if half or more of one occipital condyle is resected.
This article was published in J Neurosurg and referenced in Journal of Spine

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