Objective: To evaluate the effect of polymethylmethacrylate (PMMA) augmentation on cervical stability after anterior cervical interbody fusion (ACIF) before and after fatigue.
Methods: Twelve porcine cervical spines (C3-7) were subjected to testing angular displacement parameters, including the range of motion (ROM), neutral zone (NZ), and elastic zone (EZ), in nondestructive flexion and extension, right/left lateral bending, and left/right rotation on Motion Analysis motion capture system and MTS-858 servo-hydraulic testing machine. Intact cervical spines served as control group (group A); one-level discectomy and fusion was performed with anterior plate fixation based on group A as group B; flexion and extension, left/right lateral bending (5 000 cycles) fatigue testing based on group B as group C; the augmentation screw channel was used based on group C as group D; and flexion and extension, left/right lateral bending fatigue testing were performed based on group D as group E.
Results: The ROM, NZ, and EZ in group A were significantly different from those in other groups (P < 0.05) at flexion/extension, left/right bending, and left/right rotation. The ROM, NZ, and EZ in group B were significantly smaller than those in group C (P < 0.05) in flexion/extension, left/right bending, and left/right rotation, but there was no significant difference when compared with group D (P > 0.05). The ROM and NZ in flexion/extension and the EZ in flexion in group B were significant smaller than those in group E (P < 0.05), but there was no significant difference in the other indexes (P > 0.05). The ROM, NZ, and EZ in group C in flexion and extension, left/right lateral bending, and left/right rotation were significantly higher than those in groups D and E (P < 0.05). The ROM and NZ in flexion and extension and left/right lateral bending, and the ROM in left/right rotation, and the EZ in flexion and extension, right bending, and left/right rotation in group D were significantly smaller than those in group E (P < 0.05), but there was no significant difference in the other indexes (P > 0.05).
Conclusion: PMMA augmentation can significantly increase the instant cervical stability and provide a biomechanics basis in cervical anterior plate fixation.