The use of plate fixation in anterior surgery of the degenerative cervicalspine: a comparative prospective clinical study

The method of anterior mono- or bisegmental cervical spine fusion is a well -established procedure for degenerative conditions of the cervical spine. W hile the early reports promote fusion with bone graft alone, recent studies report superior results with the addition of anterior plating. The objecti ve of this study was to evaluate the influence of using plates in anterior cervical spine fusion in a prospective study. Fifty candidates for anterior mono- or bisegmental cervical spine fusion were randomly and prospectively selected and assigned to a plated and a non-plated group. After a minimum follow-up of 22 months, patients were clinically and radiologically examine d. The reduction in pain, improvement in neurology and functional assessmen t showed a significant improvement in both groups compared to the preoperat ive values. The total neurological score improved significantly in both gro ups, but the changes were greater in the a group with plates. There was no significant difference between the groups for fusion rating, but graft qual ity (graft height) was significantly better in the plated group. We conclud e that the overall data do not suggest better results with plating in mono- or bisegmental anterior spine fusions. Indications for additional internal fixation are restricted to special conditions with increased instability, insufficient bone quality or inappropriate graft placing.