Abstract
The use of metallic plate and screws in the anterior cervical fusion has become accepted and popular. There exist two different plating systems. However, there has been few attempt to compare surgical morbidity and clinical results either between anterior cervical fusion with and without a plating system or between two different systems in a single series of clinical study. The authors reviewed 117 patients undergoing anterior cervical fusion during the period of January 1992 to September 1996. Simple fusion without a plating system was applied in 55 (group 1), a bicortical non-locked plate screw system in 25 (group 2), and a monocortical locked plate screw system in 37 (group 3). The average follow-up period was about 13.2 months. In group 1, twenty-two patients (40%) with fracture-dislocation or corpectomy required a rigid brace such as halo brace and Minerva cast for 3 months postoperatively and seven patients (13%) experienced graft complications, mainly graft extrusion, while in groups 2 and 3, the patients required only a soft brace for 4 to 8 weeks and no patient experienced serious graft complications like graft extrusion. But two patients of screw breakage, two patients of screw back-out and one patient of non-union were observed in group 2. In comparison of the clinical complications such as hoarseness, there were no significant differences between the groups. In conclusion, a plating system in anterior cervical fusion appears to be safe in spite of its technical demands during the surgery, and to offer postoperative stability in the spine and early ambulation without a rigid brace. A monocortical locked plate screw system appears to have less hardware failure and better surgical results than a bicortical non-locked plate screw system.
