Clinical experience with a new load-sharing anterior cervical plate

2002 ◽  
Vol 1247 ◽  
pp. 563-579 ◽  
Author(s):  
Ronald I Apfelbaum ◽  
Andrew T Dailey ◽  
Scott Soleau ◽  
Jose Barbera
Keyword(s):  
Clinical Experience ◽  
Load Sharing ◽  
Cervical Plate ◽  
Anterior Cervical Plate

Stress-shielding compared with load-sharing anterior cervical plate fixation: a clinical and radiographic prospective analysis of 50 patients

2007 ◽  
Vol 6 (5) ◽  
pp. 391-397 ◽  
Author(s):  
Paul S. Saphier ◽  
Marc S. Arginteanu ◽  
Frank M. Moore ◽  
Alfred A. Steinberger ◽  
Martin B. Camins
Keyword(s):  
Stress Shielding ◽  
Load Sharing ◽  
Radiographic Evaluation ◽  
Iliac Crest Bone Graft ◽  
Prospective Analysis ◽  
Surgical Fusion ◽  
Freeze Dried ◽  
Significant Difference ◽  
Cervical Plate ◽  
Anterior Cervical Plate

Object In a prospective analysis the authors evaluated the clinical and radiographic outcome of 50 consecutive patients who underwent anterior cervical discectomy and fusion and fixation in which either a stress-shielding or a load-sharing plate (Orion and Premier, respectively) was placed. Data obtained in the two cohorts were analyzed to determine whether clinical or radiographic differences would emerge. Methods All patients underwent either one- or two-level fusion in which freeze-dried allogenic tricortical iliac crest bone graft was used. In the first cohort of 25 patients entered into the study, fixation was achieved using a stress-shielding anterior cervical plate (ACP) system, whereas in the second cohort of 25 patients a load-sharing plate system was employed. Patients were evaluated during a follow-up period that ranged from 12 to 35 months. Outcome was determined using a standard questionnaire by which the authors gauged the level of pain, disability, and satisfaction following surgery. The success of surgical fusion and the magnitude of the translation were determined by radiographic evaluation. There was no statistically significant difference between the two cohorts with respect to age, sex, smoking rate, and postoperative complications. With regard to pain and functionality, there was a significant difference (p < 0.05) in favor of the load-sharing system. The fusion rates with the load-sharing and stress-shielding systems were 96 and 92%, respectively, and this difference was not significant. There was no significant difference between the two cohorts with regard to overall satisfaction. The magnitude of vertical translation was significantly greater in the stress-shielding ACP group (p < 0.05) for treatment at one level but not at two. Clinical and radiographic data were available in all patients. Conclusions Load-sharing ACP systems exhibited superior clinical results compared with stress-shielding ACPs in this series of patients. The symptomatic pseudarthrosis rate was lower in the load-sharing ACP–treated patients, although this was not statistically significant.

Clinical and radiological evaluation of the Codman semiconstrained load-sharing anterior cervical plate: prospective multicenter trial and independent blinded evaluation of outcome

2003 ◽  
Vol 99 (3) ◽  
pp. 264-270 ◽  
Author(s):  
Steven Casha ◽  
Michael G. Fehlings
Keyword(s):  
Load Sharing ◽  
Multicenter Trial ◽  
Plate Interface ◽  
Optimal Method ◽  
Content Type ◽  
Neurological Improvement ◽  
Clinical And Radiological Outcome ◽  
Cervical Plate ◽  
Anterior Cervical Plate ◽  
Fine Print

Object. Semiconstrained load-sharing implants for spinal fixation accommodate change in the screw—plate interface as bone grafts shrink. The authors evaluated the clinical and radiological outcome in patients after placement of the Codman anterior cervical plate (ACP) system, which allows change in the screw—plate angle. Methods. The authors undertook a 10-center prospective study with independent blinded evaluation. All patients underwent cervical fusion and placement of ACPs. Clinical and radiological evaluations were performed at 1, 3, 6, 12, and 24 months. Radiographs were examined for screw angles, construct height, fusion, and screw fracture or displacement. One hundred ninety-five patients were enrolled. The mean follow-up period was 17 months. At 24 months neurological improvement was demonstrated in 68.7% and pain improvement in 76.6% of the patients. Fusion was successful in 93.8%. Varying degrees (most minor) of hardware-related failure occurred in 10.4% of cases; however, reoperation was required in only four (2.1%). A significant change in screw angles occurred over time (mean 6.4° in caudal screw angle [p < 0.001] and 2.4° in the rostral screw angle [p = 0.003]). These changes plateaued by 6 months. A change in construct height (mean 3.48 mm) occurred by 6 months (p < 0.05). Conclusions. Based on an independent blinded evaluation, the Codman ACP provides effective fixation with load sharing and is effective in achieving fusion with a 94% success rate. Direct comparison with rigidly locked devices is required to establish definitively the optimal method for anterior cervical fixation.

scholarly journals The anterior cervical plate.

1985 ◽  
Vol 34 (1) ◽  
pp. 359-361 ◽  
Author(s):  
Keiichiro Shiba ◽  
Kunio Sasaki ◽  
Kouichiro Yamano ◽  
Takayoshi Ueta ◽  
Yasushi Asakawa ◽  
...  
Keyword(s):  
Cervical Plate ◽  
Anterior Cervical Plate

Does smoking have an impact on fusion rate in single-level anterior cervical discectomy and fusion with allograft and rigid plate fixation?

2013 ◽  
Vol 19 (5) ◽  
pp. 527-531 ◽  
Author(s):  
Myles Luszczyk ◽  
Justin S. Smith ◽  
Jeffrey S. Fischgrund ◽  
Steven C. Ludwig ◽  
Rick C. Sasso ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Fusion Rate ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Single Level ◽  
Significant Difference ◽  
Solid Fusion ◽  
Cervical Plate ◽  
Anterior Cervical Plate

Object Although smoking has been shown to negatively affect fusion rates in patients undergoing multilevel fusions of the cervical and lumbar spine, the effect of smoking on fusion rates in patients undergoing single-level anterior cervical discectomy and fusion (ACDF) with allograft and plate fixation has yet to be thoroughly investigated. The objective of the present study was to address the effect of smoking on fusion rates in patients undergoing a 1-level ACDF with allograft and a locked anterior cervical plate. Methods This study is composed of patients from the control groups of 5 separate studies evaluating the use of an anterior cervical disc replacement to treat cervical radiculopathy. For each of the 5 studies the control group consisted of patients who underwent a 1-level ACDF with allograft and a locked cervical plate. The authors of the present study reviewed data obtained in a total of 573 patients; 156 patients were smokers and 417 were nonsmokers. A minimum follow-up period of 24 months was required for inclusion in this study. Fusion status was assessed by independent observers using lateral, neutral, and flexion/extension radiographs. Results An overall fusion rate of 91.4% was achieved in all 573 patients. A solid fusion was shown in 382 patients (91.6%) who were nonsmokers. Among patients who were smokers, 142 (91.0%) had radiographic evidence of a solid fusion. A 2-tailed Fisher exact test revealed a p value of 0.867, indicating no difference in the union rates between smokers and nonsmokers. Conclusions The authors found no statistically significant difference in fusion status between smokers and nonsmokers who underwent a single-level ACDF with allograft and a locked anterior cervical plate. Although the authors do not promote tobacco use, it appears that the use of allograft with a locked cervical plate in single-level ACDF among smokers produces similar fusion rates as it does in their nonsmoking counterparts.

scholarly journals Effectiveness comparison of Zero-profile interbody fusion implant and anterior cervical plate interbody fusion device: a clinical and radiological study

2020 ◽  
Author(s):  
Jun Zhang ◽  
Xiangyu Tang ◽  
Wei Xiong ◽  
Hua Wu ◽  
Chaoxu Liu ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Neck Disability Index ◽  
Operation Time ◽  
Degenerative Changes ◽  
Adjacent Segment ◽  
Fusion Device ◽  
Cage Group ◽  
Cervical Plate ◽  
Anterior Cervical Plate ◽  
Interbody Fusion Device

Abstract Purpose This study was to compare the clinical outcomes, radiographic parameters, and complications of anterior cervical discectomy and fusion (ACDF) with a Zero-profile implant (Zero-P) and traditional plate and cage. Methods There were 68 patients received ACDF of single level, 35 patients with Zero-profile implant (Zero-p group) and 33 patients with traditional plate and cage (Cage group), from C3–C7 during 2014 to 2016. Collecting and analyzing of clinical and radiological data were performed. Patients were followed-up at least 1 year after surgery. The operation time, blood loss, Japan Department of Orthopedics Association (JOA) score, pain Visual Analogue Score (VAS), Neck Disability Index (NDI) score and dysphagia score were recorded. Additionally, changes in cervical lordosis, fusion rate and adjacent segment degeneration were analyzed as well. Results For neurologic outcomes, the JOA, VAS and NDI were statistically equivalent between the two groups (P>0.05). For radiographic outcomes, there were no significant differences in the C2-7 Cobb angles, segmental Cobb angle and incidence of subsidence at the final follow-up (P>0.05). No degenerative changes was found in the Zero-p group, whereas 5 patients in the Cage group developed degeneration in adjacent segments (P<0.05). Also, the incidence of postoperative dysphagia is higher in Cage group than in Zero-p group at 3 months and 12 months (P<0.05). Conclusions Both Zero-profile implant and anterior cervical plate interbody fusion device were demonstrated to be effective and safe strategies in this study. Considering the lower incidences of dysphagia and degenerative changes, the Zero-profile implant is a good succedaneum.

Does a Zero-Profile Anchored Cage Offer Additional Stabilization as Anterior Cervical Plate?

Spine ◽  
2015 ◽  
Vol 40 (10) ◽  
pp. E563-E570 ◽  
Author(s):  
Young-Seok Lee ◽  
Young-Baeg Kim ◽  
Seung-Won Park
Keyword(s):  
Additional Stabilization ◽  
Cervical Plate ◽  
Anterior Cervical Plate

In Vitro Comparison of a Translational Anterior Cervical Plate With a Constrained Anterior Cervical Plate

2001 ◽  
Author(s):  
Denis J. DiAngelo ◽  
Weiqiang Liu ◽  
Kristine M. Olney ◽  
Kevin T. Foley
Keyword(s):  
Cervical Spine ◽  
Cervical Spondylosis ◽  
Load Transfer ◽  
Multi Level ◽  
Cervical Plate ◽  
Degenerative Disorder ◽  
Anterior Cervical Plate ◽  
Cervical Plating ◽  
In Vitro Comparison

Abstract Cervical spondylosis is the most common degenerative disorder affecting the cervical spine and is often treated surgically to prevent further neurological deterioration. However, clinical experience has shown that anterior cervical plating does not prevent construct failure in multi-level cervical corpectomy (Vaccaro et al., 1998). We have previously shown that anterior cervical plating reverses the load transfer through multi-level strut-grafts and may promote pistoning of these grafts (DiAngelo et al., 2000). The design of the anterior cervical plate (ACP) may contribute to this phenomenon. The purpose of this study was to compare the graft loading mechanics of two different anterior cervical plating systems; one with a constrained plate-screw interface versus another with a semi-constrained, translational plate-screw interface.

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