EARLY FAILURE OF LONG-SEGMENT ANTERIOR CERVICAL PLATE FIXATION

A retrospective, multicenter study was undertaken to evaluate the earl y postoperative failure rate of long segment anterior cervical fusion and plating to stabilize the cervical spine after a two- or three-leve l corpectomy for degenerative, traumatic, and neoplastic diseases of t he cervical spine. Patient demographic factors as well as technical fa ctors such as bone graft placement, plate and screw position, and post operative brace immobilization were analyzed. During the early postope rative period, the graft/plate construct dislodged in 3 of 33 patients with a two-level corpectomy and fusion (9%) compared with 6 of 12 pat ients with a three-level corpectomy and fusion (50%). The difference i n failure rates after a three- versus two-level corpectomy and Fusion was statistically significant (p < 0.05). A higher early failure rate was also seen with failure to correctly lock the screws to the plate a nd the use of a peg-in-hole type bone grafting technique, although the se differences were not statistically significant. Although several te chnical and patient-specific factors may contribute to this, anterior cervical plating and bone grafting alone after a three-level cervical corpectomy for various spinal disorders appears to afford inadequate s tability in the early postoperative period, regardless of immobilizati on methods.