Cervical Template to Optimize the Plate-to-Disc Distance in Instrumented Anterior Cervical Discectomies and Fusions: Instrumentation Assessment.
Adjacent segment degeneration
Anterior cervical discectomy and fusion
Cervical plate
Cervical radiculopathy
Plate-to-disc distance
Journal
Operative neurosurgery (Hagerstown, Md.)
ISSN: 2332-4260
Titre abrégé: Oper Neurosurg (Hagerstown)
Pays: United States
ID NLM: 101635417
Informations de publication
Date de publication:
01 07 2019
01 07 2019
Historique:
received:
16
10
2017
accepted:
21
08
2018
pubmed:
17
1
2019
medline:
24
9
2020
entrez:
17
1
2019
Statut:
ppublish
Résumé
An increased incidence of adjacent segment degeneration in the cervical spine has been associated with a plate-to-disc distance (PDD) of <5 mm. To introduce a template to size, position, and secure a cervical plate and ensure a 5-mm minimum PDD. A prospective observational study was performed on 50 consecutive patients who had single-level anterior cervical discectomy and fusion (ACDF) using a cervical template. The cervical template was secured into the interbody spacer and assessed for length, PDD, and adequate vertebral body coverage. Holes were drilled through the template, which was then removed for cervical plate placement. Postoperative radiographs were assessed for PDD to adjacent segments, the angle from the vertical axis of the spine, and distance from midline. Neck Disability Index and visual analog scale scores for the neck and arm were obtained preoperatively and at 30-d and 90-d follow-up. Fifty patients underwent single-level ACDFs. The mean angle from the long axis of the spine was 2.4 (0.0-4.4) degrees; mean distance from midline was 1.3 (0.0-2.8) mm; and mean distance from the plate ends to the adjacent segments above was 5.4 (4.6-6.2) mm, and below, 5.1 (4.3-5.8) mm. A cervical template can reliably secure the midline and predetermine the size of the shortest cervical plate for adequately stabilizing the segment for arthrodesis. Use of a template standardizes the process of maximizing the PDD.
Sections du résumé
BACKGROUND
An increased incidence of adjacent segment degeneration in the cervical spine has been associated with a plate-to-disc distance (PDD) of <5 mm.
OBJECTIVE
To introduce a template to size, position, and secure a cervical plate and ensure a 5-mm minimum PDD.
METHODS
A prospective observational study was performed on 50 consecutive patients who had single-level anterior cervical discectomy and fusion (ACDF) using a cervical template. The cervical template was secured into the interbody spacer and assessed for length, PDD, and adequate vertebral body coverage. Holes were drilled through the template, which was then removed for cervical plate placement. Postoperative radiographs were assessed for PDD to adjacent segments, the angle from the vertical axis of the spine, and distance from midline. Neck Disability Index and visual analog scale scores for the neck and arm were obtained preoperatively and at 30-d and 90-d follow-up.
RESULTS
Fifty patients underwent single-level ACDFs. The mean angle from the long axis of the spine was 2.4 (0.0-4.4) degrees; mean distance from midline was 1.3 (0.0-2.8) mm; and mean distance from the plate ends to the adjacent segments above was 5.4 (4.6-6.2) mm, and below, 5.1 (4.3-5.8) mm.
CONCLUSION
A cervical template can reliably secure the midline and predetermine the size of the shortest cervical plate for adequately stabilizing the segment for arthrodesis. Use of a template standardizes the process of maximizing the PDD.
Identifiants
pubmed: 30649439
pii: 5288178
doi: 10.1093/ons/opy279
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
43-51Informations de copyright
Copyright © 2019 by the Congress of Neurological Surgeons.