J Korean Neurosurg Soc.  2011 Apr;49(4):212-216. 10.3340/jkns.2011.49.4.212.

New Technical Tip for Anterior Cervical Plating : Make Hole First and Choose the Proper Plate Size Later

• Park JY
• Zhang HY
• Oh MC

• KMID: 1442589
• DOI: http://doi.org/10.3340/jkns.2011.49.4.212

Abstract

OBJECTIVE
It is well known that plate-to-disc distance (PDD) is closely related to adjacent-level ossification following anterior cervical plate placement. The study was undertaken to compare the outcomes of two different anterior cervical plating methods for degenerative cervical condition. Specifically, the new method involves making holes for plate screws first with an air drill and then choosing a plate size. The other method was standard, that is, decide on the plate size first, locate the plate on the anterior vertebral body, and then drilling the screw holes. Our null hypothesis was that the new technical tip may increase PDD as compared with the standard anterior cervical plating procedure.
METHODS
We retrospectively reviewed 49 patients who had a solid fusion after anterior cervical arthrodesis with a plate for the treatment of cervical disc degeneration. Twenty-three patients underwent the new anterior cervical plating technique (Group A) and 26 patients underwent the standard technique (Group B). PDD and ratios between PDD to anterior body heights (ABH) were measured using postoperative lateral radiographs. In addition, operating times and clinical results were reviewed in all cases.
RESULTS
The mean durations of follow-up were 16.42+/-5.99 (Group A) and 19.83+/-6.71 (Group B) months, range 12 to 35 months. Of these parameters mentioned above, cephalad PDD (5.43 versus 3.46 mm, p=0.005) and cephalad PDD/ABH (0.36 versus 0.23, p=0.004) were significantly greater in the Group A, whereas operation time for two segment arthrodesis (141.9 versus 170.6 minutes, p=0.047) was significantly lower in the Group A. There were no significant difference between the two groups in caudal PDD (5.92 versus 5.06 mm), caudal PDD/ABH (0.37 versus 0.32) and clinical results.
CONCLUSION
The new anterior cervical plating method represents an improvement over the standard method in terms of cephalad plate-to-disc distance and operating time.

Keyword

Cervical vertebrae; Diskectomy; Spinal fusion; Degeneration; Intervertebral disk

MeSH Terms

Arthrodesis
Body Height
Cervical Vertebrae
Diskectomy
Female
Follow-Up Studies
Humans
Intervertebral Disc
Intervertebral Disc Degeneration
Mandrillus
Retrospective Studies
Spinal Fusion