Yonsei Med J.  2013 May;54(3):726-731. 10.3349/ymj.2013.54.3.726.

Loss of Lordosis and Clinical Outcomes after Anterior Cervical Fusion with Dynamic Rotational Plates

Affiliations
  • 1Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Medical College of Hallym University, Seoul, Korea.
  • 2Department of Orthopaedic Surgery, Hallym University Sacred Heart Hospital, Medical College of Hallym University, Anyang, Korea. amhangpark@gmail.com
  • 3Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Orthopaedic Surgery, Dongtan Sacred Heart Hospital, Medical College of Hallym University, Hwaseong, Korea.

Abstract

PURPOSE
The cervical dynamic rotational plating system may induce bone graft subsidence, so it may cause loss of cervical lordosis. However there were few studies for alignments of cervical spines influencing the clinical results after using dynamic rotational plates. The purpose is to evaluate the effect of graft subsidence on cervical alignments due to the dynamic rotational cervical plates and correlating it with the clinical outcomes of patients undergoing anterior cervical fusion.
MATERIALS AND METHODS
Thirty-three patients with disease or fracture underwent anterior cervical decompression and fusion using a dynamic rotational plate. The presence and extent of implant complications, graft subsidence, loss of lordosis were identified and Visual Analog Scale score (VAS score), Japanese Orthopaedic Association score (JOA score), clinical outcomes based on Odom's criteria were recorded.
RESULTS
Fusion was achieved without implant complications in all cases. The mean graft subsidence at 6 months after the surgery was 1.46 mm. The lordotic changes in local cervical angles were 5.85degrees which was obtained postoperatively. VAS score for radicular pain was improved by 5.19 and the JOA score was improved by 3. Clinical outcomes based on Odom's criteria showed sixteen excellent, ten good and two satisfactory results. There was no significant relationship between clinical outcomes and changes in the cervical angles.
CONCLUSION
Dynamic rotational anterior cervical plating provides comparable clinical outcomes to that of the reports of former static cervical platings. The loss of lordosis is related to the amount of graft settling but it is not related to the clinical outcomes.

Keyword

Cervical alignment; subsidence; cervical fusion; dynamic rotational cervical plates

MeSH Terms

Adult
Aged
Cervical Vertebrae/*radiography/surgery
Female
Humans
Male
Middle Aged
Spinal Fusion/*adverse effects/instrumentation
Treatment Outcome

Figure

  • Fig. 1 Local cervical angle (A) and regional cervical angle (B). A negative value corresponds to a lordotic angle and a positive value indicates the presence of kyphosis.

  • Fig. 2 Bone graft subsidence, lordotic change of local cervical angle and regional cervical angle after operation.

  • Fig. 3 There was a statistically significant correlation between the degree of subsidence and the loss of lordotic local angle during the first 6 months after operation.


Cited by  1 articles

Anterior Cervical Discectomy and Fusion Alters Whole-Spine Sagittal Alignment
Jang Hoon Kim, Jeong Yoon Park, Seong Yi, Kyung Hyun Kim, Sung Uk Kuh, Dong Kyu Chin, Keun Su Kim, Yong Eun Cho
Yonsei Med J. 2015;56(4):1060-1070.    doi: 10.3349/ymj.2015.56.4.1060.


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