S-Space College of Medicine/School of Medicine (의과대학/대학원) Orthopedic Surgery (정형외과학전공) Journal Papers (저널논문_정형외과학전공)
Efficacy of a short plate with an oblique screw trajectory for anterior cervical plating: a comparative study with a two-year minimum follow-up
- Park, Jong-Hwa; Hyun, Seung-Jae; Lee, Chang-Hyun; Kim, Ki-Jeong; Yeom, Jin S.; Jahng, Tae-Ahn; Kim, Hyun-Jib
- Issue Date
- Lippincott Williams & Wilkins
- Clinical Spine Surgery, vol.29 no.1, pp. E43–E48
- anterior cervical fusion; adjacent segment ossification
development; anterior cervical plating techniques; subsidence; complications; range of motion
- Study Design: A retrospective case-control study.
Background Context: It has been reported that adjacent segment
ossification development (ASOD) commonly occurs after anterior
Objective: The aim of this study was to compare the efficacy of
the short plate and oblique screw trajectory with the traditional
long plate and parallel screw trajectory by investigating the incidence
of ASOD and graft subsidence.
Materials and Methods: We retrospectively reviewed the patients
who underwent single-level anterior cervical discectomy and fusion
(ACDF) with plate augmentation in our institute between June
2003 and August 2011. The patients were divided into 2 groups
according to the plating technique, which was determined by the
distances between the tips of the plate and the cranial and caudal
adjacent endplates (plate-to-endplate distance, PED). Group L included
the patients with a long plate (PED shorter than 5 mm), and
group S contained the patients with a short plate (PED longer than
5 mm). Vertebral body height, distribution of ACDF level, incidence
of cranial and caudal ASOD, ASOD grade, screw-to-endplate
angle, vertebral body diameter, screw length, screw-to-body
ratio, disk space height, subsidence, and cervical range of motion
were measured and compared between the 2 groups.
Results: The incidences of both cranial and caudal ASOD at least 2
years after surgery in group S were significantly lower than in group
L (17.6% vs. 53.8%, P=0.001 and 31.4% vs. 65.4%, P=0.004,
respectively). The incidence of severe ASOD at the caudal adjacent
disk space was significantly lower in group S (2.0% vs. 23.0%,
P=0.002). The incidence of the subsidence was significantly lower
in group S (2.0% vs. 25.9, P=0.001). Changes in the cervical range of motion showed no significant differences regardless of group,
ASOD, and graft subsidence.
Conclusions: Techniques using a short plate with an oblique
screw trajectory resulted in significantly reduced incidence and
severity of ASOD and prevented graft subsidence.
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