Technique of bisegmental anterior cervical interbody fusion with dynamic hybrid plates

Abstract

According to contemporary scientific literature dynamic cervical plates (DCP) are used to perform anterior cervical interbody fusion (ACIF) in cases of the cervical spine (CS) injuries and diseases more frequently in recent years. They dif-ferentiate such types of DP as translational, rotational and dynamic hybrid plates (DHP). Results of ACIF with rotational and translational DP application are widely reported in publications whereas information on analysis of translational-rotational DHP application is absent. Objective: an analysis of outcomes of clinical applica-tion of the developed cervical translational-rotational DHP in cases of surgical treatment of the cervical spine injuries and diseases. Methods: Outcomes of 11patietnts suffered due to cervical spine injuries and diseases were investigated in 8 (72,7 %) and in 3 (27,3 %) cases respectively. There were 7 (63,6 %) men and 4 (36,4 %) women. Age of patients ranged from 23 to 57years (mean age 42,4 years). One patient was excluded from our investigation because of death postoperatively. In all cases two-level ACIF was performed. The translational-rotational DHP and vertical cylindrical meshed cages (VCMC) developed at the SI «Sytenko Insitute for Spine and Joints Pathology of the NAMS of Ukraine» were used in all patients. Results: developed technique of the ACIF by means of translational-rotational DHP allowed achieving positive clinical outcomes in 90 % of cases, stable fixation in 100 % of cases, and preservation of adequate position of fixing constructs in 90 % of cases. Solid interbody fusion was achieved in all 100 % cases in optimal terms due to dynamic compression of implant within interbody space and propor-tional load sharing between all implants during entire period of treatment. The value of segmental cervical sagittal contour decreased on 2.76 degree an average during observation time that did not reflect on clinical outcomes. It was found that postoperatively translational and rotational types of dynamization started simulta-neously that is confirmed by synchronous change of screw angles in the cranial and caudal pairs of holes with the movement of the plate relatively to the screws in the oblong holes. Conclusions: two-level ACIF with using of the developed transla-tional-rotational DHP allows achieving stable fixation, high fusion rates and en-couraging clinical outcomes.