| Summary: | 碩士 === 中原大學 === 醫學工程研究所 === 92 === Under the circumstances of the traffic accidents occured at a high speed collision, the usage of safety helmets and airbags for motorcyclist and automobile passengers are likely to cause damage in the cervical spine. According to the survey from the United States National Highway Traffic Safety Administration (NHTSA), upper cervical spinal injury (occipital to C2) accounts for approximately 78 % of all cervical injuries. For the treatments of atlantoaxial instability, various surgical fixation techniques had been advocated. Most surgeons prefer posterior approaches. The stabilities of four most commonly-used C1-2 fixation devices were compared in this study. They are: (1) Halifax clamp (2) transarticular screw fixation (3) lateral mass screw-plate system (4) pedicle screw-plate system. Finite element analyses were performed for four different loading conditions in daily activities, including flexion, extension, lateral bending and axial rotation. According to the results from comparing the displacement between C1 and C2, the lateral mass screw-plate and pedicle screw-plate were the most rigid fixation and the Halifax clamp was the least rigid fixation. The stability of transarticular screws fixation was better than Halifax clamp and closer to the stability of the other two plate fixations. For comparison of the maximal von Mises stress for the four fixation devices, the pedicle screw-plate had the lowest stress and the Halifax clamp had the highest stress among the four fixation devices. From the biomechanical and clinical viewpoint, we concluded that for the treatment of C1-2 instability, the pedicle screw-plate fixation is the recommended fixation type to be used in atlantoaxial fusion surgery.
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