D. Grob et al., The use of plate fixation in anterior surgery of the degenerative cervicalspine: a comparative prospective clinical study, EUR SPINE J, 10(5), 2001, pp. 408-413
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.