S2247 Erosion of an Anterior Cervical Plate Through the Esophagus 12 Years After Surgery

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.

Download Full-text

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

10.21203/rs.3.rs-16292/v1 ◽

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.

Download Full-text

The Effect of the Anterior Cervical Plate System on Adjacent Segments: Fact or Fiction?

World Neurosurgery ◽

10.1016/j.wneu.2016.04.118 ◽

2016 ◽

Vol 94 ◽

pp. 574-575 ◽

Cited By ~ 2

Author(s):

Sheng Shi ◽

Xin-Feng Li ◽

Zu-De Liu

Keyword(s):

Cervical Plate ◽

Anterior Cervical Plate ◽

Adjacent Segments ◽

Plate System

Download Full-text

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

Spine ◽

10.1097/brs.0000000000000864 ◽

2015 ◽

Vol 40 (10) ◽

pp. E563-E570 ◽

Cited By ~ 18

Author(s):

Young-Seok Lee ◽

Young-Baeg Kim ◽

Seung-Won Park

Keyword(s):

Additional Stabilization ◽

Cervical Plate ◽

Anterior Cervical Plate

Download Full-text

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

10.1115/imece2001/bed-23036 ◽

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.

Download Full-text

Biomechanical Comparison of Integrated Fixation Cage Versus Anterior Cervical Plate and Cage in Anterior Cervical Corpectomy and Fusion (ACCF): A Finite Element Analysis

Medical Science Monitor ◽

10.12659/msm.913630 ◽

2019 ◽

Vol 25 ◽

pp. 1489-1498 ◽

Cited By ~ 2

Author(s):

Pengrong Ouyang ◽

Teng Lu ◽

Xijing He ◽

Zhongyang Gao ◽

Xuan Cai ◽

...

Keyword(s):

Finite Element Analysis ◽

Finite Element ◽

Element Analysis ◽

Cervical Corpectomy ◽

Cervical Plate ◽

Anterior Cervical Plate ◽

Biomechanical Comparison ◽

Anterior Cervical Corpectomy

Download Full-text

Outcomes observed during a 1-year clinical and radiographic follow-up of patients treated for 1- or 2-level cervical degenerative disease using a biodegradable anterior cervical plate

Journal of Neurosurgery Spine ◽

10.3171/2016.1.spine15807 ◽

2016 ◽

Vol 25 (2) ◽

pp. 205-212 ◽

Cited By ~ 6

Author(s):

Mengcun Chen ◽

Shuhua Yang ◽

Cao Yang ◽

Weihua Xu ◽

Shunan Ye ◽

...

Keyword(s):

Japanese Orthopaedic Association ◽

Fusion Rate ◽

Complication Rates ◽

Disc Disease ◽

Clinical Issue ◽

Radiographic Outcomes ◽

Cobb’S Angle ◽

Cervical Plate ◽

Anterior Cervical Plate

OBJECTIVE The purpose of this study was to present an initial surgical experience in the management of 1- or 2-level degenerative disc disease of the cervical spine using biodegradable anterior cervical plates (bACPs) in anterior cervical discectomy and fusion (ACDF). The authors also aimed to provide insight into this critical and controversial clinical issue by clarifying outcomes for patients receiving bACPs and by comparing their outcomes with those achieved using a traditional metallic anterior cervical plate (mACP) implant. METHODS A retrospective review was conducted for 2 series of patients who had undergone ACDF using either bACP (31 patients, 38 segments) or mACP (47 patients, 57 segments) instrumentation. The patients were followed up for a mean 13.5 ± 0.9 months (range 12–18 months) in the bACP group and 14.8 ± 1.5 months (range 14–22 months) in the mACP group. Clinical outcomes were determined according to scores on the visual analog scale (VAS), the modified Japanese Orthopaedic Association (mJOA) scoring system, and Odom's criteria. Radiological images were used to assess fusion rates, intervertebral height, Cobb's angle, and the width of prevertebral soft tissue. RESULTS Both VAS and mJOA scores were significantly improved at each follow-up in both groups. Excellent or good results according to Odom's criteria were achieved in 93.5% (29/31) of patients in the bACP group and 93.6% (44/47) of patients in the mACP group. At 6 months postoperatively, the fusion rate was 94.7% (36/38) in the bACP group and 96.5% (55/57) in the mACP group, but subsidence of the intervertebral space at the surgical level was more evident in the bACP group. Angulation, as measured by Cobb's angle, demonstrated obvious healing in both groups, while better maintenance was observed in the mACP group. The local inflammatory reaction was uneventful during follow-up. Dysphonia and dysphagia were observed in both groups during the follow-up. CONCLUSIONS The relatively comparable early clinical and radiographic outcomes and the overall acceptable complication rates for bACP and mACP use suggest that bACPs could be used as alternative instruments in ACDF. Mild graft resorption was noted without evidence of symptoms. However, the prospective efficacy of biodegradable instrumentation can only be elucidated with longer-term observation.

Download Full-text