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Assessment of Biomechanical Advantages in Combined Anterior-Posterior Cervical Spine Surgery by Radiological Outcomes: Pedicle Screws over Lateral Mass Screws

Authors
 Sang-Ho Kim  ;  Ji-Hyeon Kim  ;  Ji-Won Kwon  ;  Hak-Sun Kim  ;  Seong-Hwan Moon  ;  Kyung-Soo Suk  ;  Byung-Ho Lee 
Citation
 JOURNAL OF CLINICAL MEDICINE, Vol.12(9) : 1-13, 2023-04 
Journal Title
JOURNAL OF CLINICAL MEDICINE
Issue Date
2023-04
Keywords
cervical pedicle screw ; cervical sagittal balance ; combined anterior–posterior approach ; lateral mass screw ; subsidence ; vertebral body remodeling
Abstract
Background: The combined anterior-posterior approach has shown good clinical outcomes for multilevel cervical diseases. This work describes the biomechanical advantage of cervical-pedicle-screw fixation over lateral-mass-screw fixation in combined anterior-posterior cases. Method: Seventy-six patients who received combined cervical surgery from June 2013 to December 2020 were included. The patients were divided into two groups: the lateral-mass-screw group (LMS) and the pedicle-screw group (PPS). Radiological outcomes were assessed with lateral cervical spine X-rays for evaluating sagittal alignment, subsidence, and bone remodeling. Results: At 1 year postoperatively, the numbers of patients whose C2-C7 cervical lordosis was less than 20 degrees decreased by more in the PPS group (p-value = 0.001). The amount of vertical-length change from immediately to 1 year postsurgery was less in the PPS group than in the LMS group (p-value = 0.030). The mean vertebral-body-width change was larger in the PPS group than in the LMS group during 3 months to 1 year postsurgery (p-value = 0.000). Conclusions: In combined anterior-posterior cervical surgery cases, maintenance of cervical lordosis and protection of the vertebral body from subsidence were better with the pedicle-screw fixation. More bone remodeling occurred when using the pedicle-screw fixation method.
Files in This Item:
T202400685.pdf Download
DOI
10.3390/jcm12093201
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Ji-Won(권지원) ORCID logo https://orcid.org/0000-0003-4880-5310
Kim, Sang Ho(김상호) ORCID logo https://orcid.org/0000-0003-3936-1869
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Moon, Seong Hwan(문성환)
Suk, Kyung Soo(석경수) ORCID logo https://orcid.org/0000-0003-0633-2658
Lee, Byung Ho(이병호) ORCID logo https://orcid.org/0000-0001-7235-4981
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/197965
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