Open Access, Peer-reviewed
pISSN 2093-4378
eISSN 2093-4386
    J Korean Soc Spine Surg. 2005 Mar;12(1):22-27. Korean.
    Published online Mar 31, 2005.
    https://doi.org/10.4184/jkss.2005.12.1.22
    Copyright © 2005 Korean Society of Spine Surgery
    Original Article

    Influence of Plate Position on Fusion Time and Clinical Outcomes after Anterior Cervical Interbody Fusion

    June-Kyu Lee, M.D., Jae-Sung Ahn, M.D., Sang-Bum Kim, M.D.,# Chang-Hwa Hong, M.D.,# and Jung-Bum Lee, M.D.
      • Department of Orthopedic Surgery, Chungnam National University College of Medicine, Daejeon, Korea.
      • #Department of Orthopedic Surgery, Chungju St. Mary's Hospital, The Catholic University of Korea, Chungju, Korea.
    • Address reprint requests to Jae-Sung Ahn, M.D. Department of Orthopaedic Surgery, School of Medicine, Chungnam National University, #640 Daesa-Dong, Jung-Gu, Daejeon, Korea. Tel: 82-42-220-7353, Fax: 82-42-252-7098, Email: jsahn@cnu.ac.kr

    Abstract

    Study Design

    This was a retrospective study to evaluate anterior cervical interbody fusion with plates.

    Objective

    To examine the degree of angulation and translation after an anterior interbody fusion, using anterior plate fixation, upon the fusion rate and clinical outcome.

    Summary of Literature Review

    Anterior cervical interbody fusion with plate allows immediate rigid internal fixation after decompression and bone grafting

    Materials and Methods

    65 cases had an anterior interbody fusion on the cervical spine, using an anterior approach and Smith-Robinson's method, between January 1998 and August 2003. Of these, 41 cases, which could be followed up for at least one year, were selected. There were 26 and 15 males and females, respectively, with an average age of 43.5 and mean follow up period of 2.1 years. 15 cases underwent an operation due to dislocation or fracture of the cervical spine due to trauma, and 26 due to cervical diseases. The angulation and translation of the plate was measured by postoperative X-rays. The fusion rate was also determined by the follow up X-rays. The Chi-squared test was used to analyze the data.

    Results

    Bony fusion was obtained in all cases. Two patients developed hoarseness and one showed torticollis, but all had recovered by the follow up. The average angulation of the plate and translation were 6.2 degrees and 3.21mm, respectively, but there was no significant difference of the interbody fusion period due to angulation and translation of the plate or in the improvement of the clinical outcomes.

    Conclusion

    In the cases of anterior interbody fusion of the cervical spine, the angulation and translation of the plate had no influence on the fusion time and clinical outcomes. Long term studies and research will be needed to bring about clinically more valuable data.

    Keywords
    Cervical spine; Anterior interbody fusion; Plate angulation; Plate translation

    Figures

    Fig. 1
    The measurement of angulation and translation of the anterior plates. (a: angulation, b: translation)

    Tables

    Table 1-1
    The relationship of the angulation of plates and fusion period.

    Table 1-2
    The relationship of the translation of plates and fusion period.

    Table 2-1
    The relationship of the angulation of plates and clinical results.

    Table 2-2
    The relationship of the translation of plates and clinical results.

    References

      1. Robinson RA, Smith SW. Anterolateral cervical disc removing and interbody fusion for cervical disc syndrome. Bull John Hopkins Hospital 1955;96:223–224.
      1. Bohlmann HH, Emery SE, Goodfellow DB. Robinson anterior cervical discectomy and arthrodesis for cervical radiculoapthy. Instr Course Lect Am Acad Orthop Surg 1993;75:1298–1307.
      1. Bohlmann HH. Cervical spondylosis with moderate to severe myelopathy: A report of seventeen cases treated by Robinson anterior cervical discectomy and fusion. Spine 1977;2:151–156.
      1. Bohler J, Gaudernak T. Anterior plate stabilization for fracture-dislocation of the lower cervical spine. J Trauma 1980;20:203–205.
      1. Brener AM, Nguyen TQ. Internal metal plate fixation combined with anterior interbody fusion in cases of cervical spine injury. Neurosurgery 1983;12:649–653.
      1. Casper W, Barbier DD, Klara PM. Anterior cervical fusion and Casper plate stabilization for cervical trauma. Neurosurgery 1989;25:491–502.
      1. Vaccaro AR, Falatyn SP, Scuderi GJ. Early failure of long segment anterior cervical plate fixation. J Spinal Disord 1998;11:410–415.
      1. Brantigan JW. Pseudarthrosis rate after allograft posterior lumbar interbody fusion with pedicle screw and plate fixation. Spine 1994;19:1271–1280.
      1. Bell GD, Bailey SI. Anterior cervical fusion for trauma. Clin Orthop 1977;128:155–158.
      1. Wang JC, McDonough PW, Endow K, Kanim LE, Delamarter RB. The effect of cervical plating on single-level anterior cervical discectomy and fusion. J Spinal Disord 1999;12:467–471.
      1. Griffith SL, Zobgi SW, Guyer RD, Shelokov AP, Contiliano JH, Geiger JM. Biomechanical comparison of anterior instrumentation for the cervical spine. J Spinal Disord 1995;8:429–438.
      1. Karasick D. Anterior cervical spine fusion. Struts, plugs and plates. Skeletal Radiol 1993;22:85–94.
      1. Brunton FJ, Wilkinson JA, Wise KSH, Simmonis RB. Cineradiography in cervical spondylolysis as a means of determining the level for anterior fusion. J Bone Joint Surg 1982;64-B:399–404.
      1. Clements DH, O'leary PF. Anterior cervical discectomy and fusion. Spine 1990;15:1023–1025.
      1. Gore DR, Sepic SB. Anterior cervical fusion for degenerated or protruded disc. A review of one hundred forty-six patients. Spine 1984;9:667–671.
      1. Stauffer S, Kelly EG. Fracture-dislocation of the cervical spine instability and recurrent deformity following treatment by anterior interbody fusion. J Bone Joint Surg 1977;59-A:45–47.
      1. Brodsky AE, Khalili MA, Sassard WR, Newman BP. Repair of symptomatic pseudarthrosis of anterior cervical fusion. Posterior versus anterior repair. Spine 1992;17:1137–1143.
      1. Farey ID, McAfee P, Davis RF, Long DM. Pseudarthrosis of the cervical spine after anterior arthrodesis. Treatment by posterior nerve root decompression, stabilization, and arthrodesis. J Bone Joint Surg 1990;72:1171–1177.
      1. Wang JC, McDonough PW, Kanim LE, Endow KK, Delamarter RB. Increased fusion rates with cervical plating for three-level anterior cervical plating for three-level anterior cervical discectomy and fusion. Spine 2001;26:643–646.
      1. Emery SE, Fisher JR, Bohlman HH. Three level anterior cervical discectomy and fusion. Radiographic and clinical results. Spine 1999;22:2622–2624.
      1. Robinson RA, Walker AE, Ferlic DC, Wiecking DK. The results of anterior interbody fusion of the cervical spine. J Bone Joint Surg 1962;44:1569–1587.
      1. Zdeblick TA, Ducker TB. The use of freeze-dried allograft bone for anterior cervical fusions. Spine 1991;16:726–729.
    Cited by
    Crossref 3
    Google Scholar 
    MeSH Terms
    Bone Transplantation
    Decompression
    Dislocations
    Female
    Follow-Up Studies
    Hoarseness
    Humans
    Male
    Retrospective Studies
    Spine
    Torticollis
    Metrics
    Share
    Figures
    slide

    1 / 1

    Tables
    slide
    slide
    slide
    slide

    1 / 4

    PERMALINK