Is the anterior cervical dynamic plate fixation better than the anterior static plate fixation: a retrospective review with over 5 years follow-up

Abstract Background To compare the clinical and radiologic outcomes after anterior cervical dynamic or static plate fixation for short segment cervical degenerative disc diseases (DDD) for more than 5 years. Methods Sixty-four patients who underwent anterior cervical one level discectomy or corpecto...

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Main Authors: Chao Li, Qing He, Yue Zhu, Zuqiang Wang
Format: Article
Language:English
Published: BMC 2023-01-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12891-023-06156-9
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author Chao Li
Qing He
Yue Zhu
Zuqiang Wang
author_facet Chao Li
Qing He
Yue Zhu
Zuqiang Wang
author_sort Chao Li
collection DOAJ
description Abstract Background To compare the clinical and radiologic outcomes after anterior cervical dynamic or static plate fixation for short segment cervical degenerative disc diseases (DDD) for more than 5 years. Methods Sixty-four patients who underwent anterior cervical one level discectomy or corpectomy with an anterior cervical plate system were followed for an average of 6.8 years for clinical and radiographic outcomes. Among the sixty-four patients, thirty-eight patients were fixed with a static plate (ORION and CSLP plate system) and the other twenty-six patients were fixed with a dynamic plate (ABC plate). Radiographic data were collected included the global sagittal alignment of the cervical spine (C2–C7), the local height and angle of the operated level pre-operatively, postoperatively and at last follow-up. A clinical assessment was performed at pre-operatively, three months postoperatively and final follow-up using the Japanese Orthopedic Association (JOA) /Visual Analogue Score(VAS)/ Neck Disablility Index(NDI) scoring system. Results The mean follow-up time was 6.8 years. At final review, there were two cases of suspicious pseudarthrosis which were from ABC plate fixation group while the other cases all gained solid fusion. The height of fusion segment gained significantly improvement for both dynamic and static plate group post-operation, and all groups demonstrated a significant loss in height postoperatively. Generally, for the one level ACDF group, the height decrease was 0.5 mm for static plate and 1.6 mm for dynamic group which was significantly different(p < 0.05). And for one level ACCF group, this type of difference was not seen in which decreasing was 1.7 mm for static group and 1.8 mm for dynamic group. Segmental lordosis of the fusion segments was increased significantly both post-operation and final follow-up than before-operation for both one and two segments fusion. Global cervical lordosis from C2–C7 was increased in the early postoperative period in all groups, and at final follow-up the total lordosis was still getting better compared with early postoperative period, but this increase was not statistically significant. Clinical assessment of JOA/NDI showed that there was significantly improvement 3-month post-operation compared with pre-operation, and the score could get a slight further improvement at the final follow-up. Conclusion Our study demonstrated a statistically similar fusion rate between dynamic and static cervical plate fixation. However, the height gained with static plate fixation for single segment disease was maintained better than with dynamic plate fixation and there was no difference between JOA outcome scores between groups. Despite the reported improved biomechanics of dynamic plate fixation, further research needs to be done to show the clinical advantage of dynamic plate fixation.
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spelling doaj.art-0dc1dd45b66c4e4891556f1998abf1be2023-01-22T12:02:12ZengBMCBMC Musculoskeletal Disorders1471-24742023-01-012411810.1186/s12891-023-06156-9Is the anterior cervical dynamic plate fixation better than the anterior static plate fixation: a retrospective review with over 5 years follow-upChao Li0Qing He1Yue Zhu2Zuqiang Wang3Department of Orthopedics, The Sixth Medical Center, General Hospital of Chinese PLADepartment of Orthopedics, The Sixth Medical Center, General Hospital of Chinese PLADepartment of Orthopedics, The Sixth Medical Center, General Hospital of Chinese PLADepartment of Orthopedics, The Sixth Medical Center, General Hospital of Chinese PLAAbstract Background To compare the clinical and radiologic outcomes after anterior cervical dynamic or static plate fixation for short segment cervical degenerative disc diseases (DDD) for more than 5 years. Methods Sixty-four patients who underwent anterior cervical one level discectomy or corpectomy with an anterior cervical plate system were followed for an average of 6.8 years for clinical and radiographic outcomes. Among the sixty-four patients, thirty-eight patients were fixed with a static plate (ORION and CSLP plate system) and the other twenty-six patients were fixed with a dynamic plate (ABC plate). Radiographic data were collected included the global sagittal alignment of the cervical spine (C2–C7), the local height and angle of the operated level pre-operatively, postoperatively and at last follow-up. A clinical assessment was performed at pre-operatively, three months postoperatively and final follow-up using the Japanese Orthopedic Association (JOA) /Visual Analogue Score(VAS)/ Neck Disablility Index(NDI) scoring system. Results The mean follow-up time was 6.8 years. At final review, there were two cases of suspicious pseudarthrosis which were from ABC plate fixation group while the other cases all gained solid fusion. The height of fusion segment gained significantly improvement for both dynamic and static plate group post-operation, and all groups demonstrated a significant loss in height postoperatively. Generally, for the one level ACDF group, the height decrease was 0.5 mm for static plate and 1.6 mm for dynamic group which was significantly different(p < 0.05). And for one level ACCF group, this type of difference was not seen in which decreasing was 1.7 mm for static group and 1.8 mm for dynamic group. Segmental lordosis of the fusion segments was increased significantly both post-operation and final follow-up than before-operation for both one and two segments fusion. Global cervical lordosis from C2–C7 was increased in the early postoperative period in all groups, and at final follow-up the total lordosis was still getting better compared with early postoperative period, but this increase was not statistically significant. Clinical assessment of JOA/NDI showed that there was significantly improvement 3-month post-operation compared with pre-operation, and the score could get a slight further improvement at the final follow-up. Conclusion Our study demonstrated a statistically similar fusion rate between dynamic and static cervical plate fixation. However, the height gained with static plate fixation for single segment disease was maintained better than with dynamic plate fixation and there was no difference between JOA outcome scores between groups. Despite the reported improved biomechanics of dynamic plate fixation, further research needs to be done to show the clinical advantage of dynamic plate fixation.https://doi.org/10.1186/s12891-023-06156-9CervicalDynamic platingStatic platingACDF
spellingShingle Chao Li
Qing He
Yue Zhu
Zuqiang Wang
Is the anterior cervical dynamic plate fixation better than the anterior static plate fixation: a retrospective review with over 5 years follow-up
BMC Musculoskeletal Disorders
Cervical
Dynamic plating
Static plating
ACDF
title Is the anterior cervical dynamic plate fixation better than the anterior static plate fixation: a retrospective review with over 5 years follow-up
title_full Is the anterior cervical dynamic plate fixation better than the anterior static plate fixation: a retrospective review with over 5 years follow-up
title_fullStr Is the anterior cervical dynamic plate fixation better than the anterior static plate fixation: a retrospective review with over 5 years follow-up
title_full_unstemmed Is the anterior cervical dynamic plate fixation better than the anterior static plate fixation: a retrospective review with over 5 years follow-up
title_short Is the anterior cervical dynamic plate fixation better than the anterior static plate fixation: a retrospective review with over 5 years follow-up
title_sort is the anterior cervical dynamic plate fixation better than the anterior static plate fixation a retrospective review with over 5 years follow up
topic Cervical
Dynamic plating
Static plating
ACDF
url https://doi.org/10.1186/s12891-023-06156-9
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