| ABSTRACT: |
The use of anterior plates for single-level
cervical fusions is controversial. Previous studies that evaluated single
and multiple-level fusions have shown increased and decreased fusion rates
when cervical plates are used. The purpose of this study was to compare
the clinical and radiographic success of single-level discectomy performed
with and without anterior cervical plate fixation. During a 6-year period,
80 patients were surgically treated with a single-level anterior cervical
discectomy. Forty-four patients had cervical plates, whereas 36 had fusions
without plates (average follow-up, 2.3 years). The pseudarthrosis rates
were 4.5% (2 of 44) for patients with plating and 8.3% (3 of 36) without
plating. This difference was not significant (p = 0.653). There was no correlation
of pseudarthrosis with sex, age, level of surgery, history of tobacco use,
or the presence of previous anterior surgery. The amount of graft collapse
for patients with plating was 0.75 mm compared with 1.5 mm for those without
a plate (p = 0.026). The amount of kyphotic deformity of the fused segment
was 1.2 degrees with plating compared with 1.9 degrees for patients without
plating (p = 0.079). Ninety-one percent of the patients with plating had
good or excellent results compared with 88% in the group without cervical
plates, based on Odom's criteria. The addition of plate fixation for single-level
anterior cervical discectomy and fusion is safe and not associated with
a significant increase in complication rates. The pseudarthrosis rates are
not significantly different when a cervical plate is used. |