ANTERIOR CERVICAL PLATE STABILIZATION IN ONE-LEVEL AND 2-LEVEL DEGENERATIVE DISEASE - OVERTREATMENT OR BENEFIT

This consecutive case retrospective chart review of 356 patients compa res the reoperation rate of one-and two-level anterior cervical discec tomies for degenerative disease with and without anterior cervical pla te stabilization (ACPS). A total of 210 patients underwent surgery wit hout ACPS(bone alone) and 146 patients underwent surgery with the addi tion of ACPS. Follow-up ranged from 1 to 9 years. A total of 22 patien ts with one-or two-level cervical arthrodesis required a second surgic al intervention (19 bone alone, 3 with ACPS). Reoperations were perfor med in the bone-alone group for pseudarthrosis in 12 cases and for pro gression of degenerative disease in 7 cases. The reoperations in the A CPS group were performed for pseudarthrosis in one case and settling o f the graft with screw fracture before fusion in two cases. The log-ra nk test, which uses all patients and their total follow-up periods, wa s statistically significant in favoring ACPS (p = 0.05). Furthermore, the reoperation rate after 1 year was also significantly lower when AC PS was utilized compared with bone alone (p = 0.0308, Fisher's exact t est, two tailed). These data provide evidence that the addition of ACP S in one-and two-level cervical degenerative disease does not constitu te overtreatment but rather supplements the internal stabilization ini tially provided by the bone graft and yields a lower reoperation rate.