Surgical outcome of single segment ventral fusion with plate osteosynthesis in therapy refractory chronic cervico-brachialgia

Abstract

In anterior cervical stabilization, collapses of the grafted bone with resulting localized kyphosis and graft dislocation has been reported. It was the aim of this clinical trial to evaluate the benefit of additional plating while taking specific implant-related complications into account. The results of single level anterior cervical spinal fusion were evaluated. In 44 patients suffering from chronic cervical radicular pain with degenerative changes, arthrodesis with iliac-crest bone and plate fixation was performed. Apart from clinical parameters, the pre- and postoperative segmental kyphosis and cervical lordosis were evaluated. The total cervical alignment increased from 15.4 degrees to 18.5 degrees while the alignment of the fused segment increased from 2.6 degrees to 7.7 degrees. Postoperative decrease of correction did not occur. Bony fusion was confirmed in 95% after 12 months and 100% aller 36 months. Our results show that patients had more relief from radicular pain (80%) than from unspecific neck pain (66%). In single level anterior cervical fusion, additional plating successfully prevents dislocation of the bone graft and postoperative kyphosis. The clinical results and pseudarthrosis rate do not differ from studies without plating. Long. term follow-up studies are necessary to show the benefit of the reduced postoperative kyphosis.