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. 2023 Sep 18:38:e383223.
doi: 10.1590/acb383223. eCollection 2023.

Biomechanical evaluation of four surgical techniques for ventral stabilization of the atlantoaxial joint in dogs

Danyelle Rayssa Cintra Ferreira  1 , Luís Gustavo Gosuen Gonçalves Dias  1 , Bruno Watanabe Minto  1 , Thiago André Salvitti de Sá Rocha  2 , Caio Afonso Dos Santos Malta  1 , Maria Eduarda Bastos Andrade Moutinho da Conceição  1 , Dayvid Vianêis Farias de Lucena  1
Affiliations

Biomechanical evaluation of four surgical techniques for ventral stabilization of the atlantoaxial joint in dogs

Danyelle Rayssa Cintra Ferreira et al. Acta Cir Bras. .

Abstract

Purpose: This study compared, through biomechanical evaluation under ventral flexion load, four surgical techniques for ventral stabilization of the atlantoaxial joint in dogs.

Methods: In total, 28 identical atlantoaxial joint models were created by digital printing from computed tomography images of a dog, and the specimens were divided into four groups of seven. In each group, a different technique for ventral stabilization of the atlantoaxial joint was performed: transarticular lag screws, polyaxial screws, multiple screws and bone cement (polymethylmethacrylate-PMMA), and atlantoaxial plate. After the stabilization technique, biomechanical evaluation was performed under ventral flexion load, both with a predefined constant load and with a gradually increasing load until stabilization failure.

Results: All specimens, regardless of stabilization technique, were able to support the predefined load without failing. However, the PMMA method provided significant more rigidity (p ≤ 0.05) and also best resisted the gradual increase in load, supporting a significantly higher maximum force (p ≤ 0.05). There was no statistical difference in flexural strength between the transarticular lag screws and plate groups. The polyaxial screws method was significantly less resistant to loading (p ≤ 0.05) than the other groups.

Conclusions: The PMMA technique had biomechanical advantages in ventral atlantoaxial stabilization over the other evaluated methods.

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Conflict of interest statement

Conflict of interest: Nothing to declare.

Figures

Figure 1
Figure 1. Photographic images of the specimen created by digital printing from computed tomography images representing the ventral aspect of the first and second cervical vertebrae of a dog. (a) Ventral view; (b) oblique view.
Figure 2
Figure 2. Photographic images of the atlantoaxial three-dimensional drill guides (3DDG) and the mold to accommodate the polymethylmethacrylate (PMMA). (a) 3DDG for the transarticular screws group (ventrolateral view); (b) 3DDG for the polyaxial screws group (ventrocaudal view); (c) 3DDG for the multiple screws and PMMA group (ventrolateral view); (d) mold to accommodate the PMMA (ventrolateral view).
Figure 3
Figure 3. Photographic images of a specimen of each group after the stabilization technique (ventral aspect). (a) Transarticular lag screws; (b) polyaxial screws; (c) multiple screws and polymethylmethacrylate; (d) atlantoaxial plate.
Figure 4
Figure 4. Boxplots representing the quartiles of stiffness (N/mm) and deflection (mm) values for the transarticular lag screws (LAG), polyaxial screws (PXS), multiple screws and PMMA (PMMA), and atlantoaxial plate (PLATE) when subjected to a load of 25 N in the ventral direction.
Figure 5
Figure 5. Boxplot representing the quartiles of maximum force (N) values for the transarticular lag screws (LAG), polyaxial screws (PXS), multiple screws and PMMA (PMMA), and atlantoaxial plate (PLATE) under ventral flexion force.
See this image and copyright information in PMC

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