Anterior cervical plate stabilization in one- and two-level degenerative disease: overtreatment or benefit?

J Spinal Disord. 1998 Feb;11(1):1-11.

Abstract

This consecutive case retrospective chart review of 356 patients compares the reoperation rate of one- and two-level anterior cervical discectomies for degenerative disease with and without anterior cervical plate stabilization (ACPS). A total of 210 patients underwent surgery without ACPS (bone alone) and 146 patients underwent surgery with the addition of ACPS. Follow-up ranged from 1 to 9 years. A total of 22 patients with one- or two-level cervical arthrodesis required a second surgical intervention (19 bone alone, 3 with ACPS). Reoperations were performed in the bone-alone group for pseudarthrosis in 12 cases and for progression of degenerative disease in 7 cases. The reoperations in the ACPS group were performed for pseudarthrosis in one case and settling of the graft with screw fracture before fusion in two cases. The log-rank test, which uses all patients and their total follow-up periods, was statistically significant in favoring ACPS (p = 0.05). Furthermore, the reoperation rate after 1 year was also significantly lower when ACPS was utilized compared with bone alone (p = 0.0308, Fisher's exact test, two tailed). These data provide evidence that the addition of ACPS in one- and two-level cervical degenerative disease does not constitute overtreatment but rather supplements the internal stabilization initially provided by the bone graft and yields a lower reoperation rate.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Screws
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / pathology
  • Cervical Vertebrae / surgery*
  • Diskectomy*
  • Female
  • Humans
  • Ilium / transplantation
  • Male
  • Middle Aged
  • Radiography
  • Retrospective Studies
  • Spinal Diseases / diagnostic imaging
  • Spinal Diseases / surgery*
  • Spinal Fusion*