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KEY FACTS
Terminology
Pre-Procedure
TERMINOLOGY
Abbreviations
- Anterior cervical plate (ACP)
- Anterior cervical discectomy and fusion (ACDF)
Synonyms
- Ventral cervical plates
Plate Types
- Unrestricted backout devices
- Bicortical, nonlocked screws
- Restricted backout devices
- Unicortical, locked screws
- Constrained: Locked screws and no construct motion
- Semiconstrained: Locked screws but construct motion allowed
- Rotational: Rotational motion allowed at screw/plate interface
- Translational: Rotational and translational motion allowed at screw/plate interface
- Unicortical, locked screws
- Unrestricted backout no longer utilized
- Caspar and Orozco plate systems in the 1980s
- Required bicortical screw purchase
- Nonlocking and rigid systems with screw angulation determined by surgeon preference
- Complications
- High rates of screw backout and breakage
- Graft subsidence
- Risk of neural injury with bicortical purchase
- Complications
- Restricted backout: Constrained plates
- Archetype is Synthes cervical spine locking plate (CSLP) (Synthes)
- Introduced into USA in early 1990s
- Other type is Orion plating system
- Does not require bicortical purchase
- Titanium expansion screw fixes screw to plate
- Ease of application
- No need for C-arm fluoroscopy since unicortical
- Rare screw backout
- Archetype is Synthes cervical spine locking plate (CSLP) (Synthes)
- Restricted backout: Semiconstrained plates
- Rotational: Codman system
- Variability in screw direction allowed, with cam-locking system to prevent screw backout
- Complications
- With multilevel constructs, rotation can lead to graft dislodgement
- Translational: DOC plate system (Acromed), ABC system (Aesculap)
- DOC: Screws do not pivot but slide along a rail
- ABC: Screws translate in a slot and may then rotate after maximum translation
- Rotational: Codman system
- Unrestricted backout devices
PRE-PROCEDURE
Indications
POST-PROCEDURE
Expected Outcome
Selected References
- Jacobs W et al: Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease. Cochrane Database Syst Rev. (1):CD004958, 2011
- Aebi M: Surgical treatment of upper, middle and lower cervical injuries and non-unions by anterior procedures. Eur Spine J. 19 Suppl 1:S33-9, 2010
- Cagli S et al: Cervical screw missing secondary to delayed esophageal fistula: case report. Turk Neurosurg. 19(4):437-40, 2009
- Solerio D et al: Successful surgical management of a delayed pharyngo-esophageal perforation after anterior cervical spine plating. Eur Spine J. 17 Suppl 2:S280-4, 2008
- Fountas KN et al: Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976). 32(21):2310-7, 2007
- Koller H et al: 4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results. Eur Spine J. 16(12):2055-71, 2007
- Resnick DK et al: Use of ventral plates for cervical arthrodesis. Neurosurgery. 60(1 Supp1 1):S112-7, 2007
- Angevine PD et al: Cost-effectiveness of single-level anterior cervical discectomy and fusion for cervical spondylosis. Spine (Phila Pa 1976). 30(17):1989-97, 2005
- Rhee JM et al: Indications and techniques for anterior cervical plating. Neurol India. 53(4):433-9, 2005
- Moftakhar R et al: Anterior cervical plates: a historical perspective. Neurosurg Focus. 16(1):E8, 2004
- Haid RW et al: The Cervical Spine Study Group anterior cervical plate nomenclature. Neurosurg Focus. 12(1):E15, 2002
- DiAngelo DJ et al: Anterior cervical plating reverses load transfer through multilevel strut-grafts. Spine (Phila Pa 1976). 25(7):783-95, 2000
- Kirkpatrick JS et al: Reconstruction after multilevel corpectomy in the cervical spine. A sagittal plane biomechanical study. Spine (Phila Pa 1976). 24(12):1186-90; discussion 1191, 1999
- Panjabi MM et al: Loosening at the screw-vertebra junction in multilevel anterior cervical plate constructs. Spine (Phila Pa 1976). 24(22):2383-8, 1999
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Pre-Procedure
TERMINOLOGY
Abbreviations
- Anterior cervical plate (ACP)
- Anterior cervical discectomy and fusion (ACDF)
Synonyms
- Ventral cervical plates
Plate Types
- Unrestricted backout devices
- Bicortical, nonlocked screws
- Restricted backout devices
- Unicortical, locked screws
- Constrained: Locked screws and no construct motion
- Semiconstrained: Locked screws but construct motion allowed
- Rotational: Rotational motion allowed at screw/plate interface
- Translational: Rotational and translational motion allowed at screw/plate interface
- Unicortical, locked screws
- Unrestricted backout no longer utilized
- Caspar and Orozco plate systems in the 1980s
- Required bicortical screw purchase
- Nonlocking and rigid systems with screw angulation determined by surgeon preference
- Complications
- High rates of screw backout and breakage
- Graft subsidence
- Risk of neural injury with bicortical purchase
- Complications
- Restricted backout: Constrained plates
- Archetype is Synthes cervical spine locking plate (CSLP) (Synthes)
- Introduced into USA in early 1990s
- Other type is Orion plating system
- Does not require bicortical purchase
- Titanium expansion screw fixes screw to plate
- Ease of application
- No need for C-arm fluoroscopy since unicortical
- Rare screw backout
- Archetype is Synthes cervical spine locking plate (CSLP) (Synthes)
- Restricted backout: Semiconstrained plates
- Rotational: Codman system
- Variability in screw direction allowed, with cam-locking system to prevent screw backout
- Complications
- With multilevel constructs, rotation can lead to graft dislodgement
- Translational: DOC plate system (Acromed), ABC system (Aesculap)
- DOC: Screws do not pivot but slide along a rail
- ABC: Screws translate in a slot and may then rotate after maximum translation
- Rotational: Codman system
- Unrestricted backout devices
PRE-PROCEDURE
Indications
POST-PROCEDURE
Expected Outcome
Selected References
- Jacobs W et al: Single or double-level anterior interbody fusion techniques for cervical degenerative disc disease. Cochrane Database Syst Rev. (1):CD004958, 2011
- Aebi M: Surgical treatment of upper, middle and lower cervical injuries and non-unions by anterior procedures. Eur Spine J. 19 Suppl 1:S33-9, 2010
- Cagli S et al: Cervical screw missing secondary to delayed esophageal fistula: case report. Turk Neurosurg. 19(4):437-40, 2009
- Solerio D et al: Successful surgical management of a delayed pharyngo-esophageal perforation after anterior cervical spine plating. Eur Spine J. 17 Suppl 2:S280-4, 2008
- Fountas KN et al: Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976). 32(21):2310-7, 2007
- Koller H et al: 4- and 5-level anterior fusions of the cervical spine: review of literature and clinical results. Eur Spine J. 16(12):2055-71, 2007
- Resnick DK et al: Use of ventral plates for cervical arthrodesis. Neurosurgery. 60(1 Supp1 1):S112-7, 2007
- Angevine PD et al: Cost-effectiveness of single-level anterior cervical discectomy and fusion for cervical spondylosis. Spine (Phila Pa 1976). 30(17):1989-97, 2005
- Rhee JM et al: Indications and techniques for anterior cervical plating. Neurol India. 53(4):433-9, 2005
- Moftakhar R et al: Anterior cervical plates: a historical perspective. Neurosurg Focus. 16(1):E8, 2004
- Haid RW et al: The Cervical Spine Study Group anterior cervical plate nomenclature. Neurosurg Focus. 12(1):E15, 2002
- DiAngelo DJ et al: Anterior cervical plating reverses load transfer through multilevel strut-grafts. Spine (Phila Pa 1976). 25(7):783-95, 2000
- Kirkpatrick JS et al: Reconstruction after multilevel corpectomy in the cervical spine. A sagittal plane biomechanical study. Spine (Phila Pa 1976). 24(12):1186-90; discussion 1191, 1999
- Panjabi MM et al: Loosening at the screw-vertebra junction in multilevel anterior cervical plate constructs. Spine (Phila Pa 1976). 24(22):2383-8, 1999
