Analyse 3D du comportement mécanique de l’os spongieux pour l’étude de fixations occipito-cervicales

Cette étude porte sur l’analyse du comportement mécanique de l’os spongieux humain lors d’un essai de compression. La microtomographie RX couplée à la corrélation d’images volumiques permet d’observer les déformations de la microstructure osseuse durant un chargement mécanique. Ces mesures apportent alors de nouvelles connaissances sur le comportement mécanique de l’os humain notamment pour aborder les problèmes liés à la mise en place de matériel d’ostéosynthèse

Should we recommend occipital plate fixation using bicortical screws or inverted occipital hooks to optimize occipito-cervical junction fusion? A biomechanical study combining an experimental and analytical approach.

International audienceBackgroundOccipito-cervical fusion can be necessary in case of cranio-cervical junction instability. Proximal stabilisation is usually ensured by bi-cortical occipital screws implanted through one median or two lateral occipital plate(s). Bone thickness variability as well as the proximity of vasculo-nervous elements can induce substantial morbidity. The choice of site and implant type remains difficult for surgeons and is often empirically based. Given this challenge, implants with smaller pitch to increase bone interfacing are being developed, as is a surgical technique consisting in inverted occipital hook clamps, a potential alternative to plate/screws association. We present here a biomechanical comparison of the different occipito-cervical fusion devices