Comparison between Constrained and Non-Constrained Plate System in Anterior Cervical Fusion

Abstract

Anterior fusion of cervical spine with screw-plates is gaining popularity in the management of anterior cervical spine instability. We report our surgical results with anterior cervical fusion using constrained and non-constrained plate system. Pathology included cervical spondylosis in 40, cervical spine trauma in 66, cervical disc disease in 43, and ossification of posterior longitudinal ligament in 3 patients. 152 consecutive cases, 110 men and 42 women, underwent discectomy and multilevel corpectomies or spondylectomies using a modified Smith-Robinson procedure with various plate systems, Caspar plate in 14, Top plate in 102, and Orion plate in 21 patients. 15 patients underwent surgery without plate system. The mean follow-up period was 17 months (range 12-30 months). Dislodgement of bone graft or screw loosening and fusion failure that required reoperation occurred in 8 patients. All of these cases are those operated using non-constrained system or without plate system. However, in the group with the constrained system we did not observe any hardware-related complications and the fusion rate was 100% during the follow-up period. Anterior cervical fusion with screw-plate system can be carried out with acceptable complication rate. We conclude that the use of the constrained plate system yields better results than the non-constrained system, and it is a safe and effective method to provide reliable stabilization of the cervical spine.