Angular Stable Plates in Lower Cervical Spine Fractures

Abstract

This study evaluates the results of operative treatment of lower cervical spine injuries stabilised with angular stable plates and screws. It is a retrospective study of anterior spondylodesis carried out to stabilise unstable lower cervical spine injuries. From 1994 to 2001, 131 anterior spondylodeses were performed. One segment was fused in 116 (88.5 %) cases and two segments were fused in 15 (11.5 %) cases. Preoperative realignment was achieved by halo traction followed by operative decompression and stabilisation. Ruptured discs or fractured vertebral bodies were removed and fusion was performed using tricortical autologous bone grafts with angular stable plates and screw fixation. In 131 cases of anterior spondylodesis, 125 (95.4 %) fused solidly in an average of 3.4 months. In 4 (3 %) cases pseudarthrosis occurred and in 2 (2.5 %) cases dislocation of instrumentation was found. All cases of pseudarthrosis required further surgery. Repeated plate breakage occurred in one patient but due to the absence of clinical signs or symptoms of instability no further surgery was performed. In the 2 cases of dislocation of screws and plates, reosteosynthesis resulted in solid fusion. Both of these patients suffered from ankylosing spondylitis. Our results of fusion (95.4 %) using angular stable plates and screws are comparable to other results available in the literature. The reason for the occurrence of pseudarthrosis is not clear. Early and over vigorous physical exercise may contribute. In patients with ankylosing spondylitis, reduced bone quality probably caused the dislocation of screws and the resulting non-union.

Key words

cervical spine fractures - anterior spondylodesis - angular stable plate fixation

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