Cervical Stabilization by Plate and Bone Fusion

Brown, Jeffrey A.; Havel, Paul; Ebraheim, Nabil A.; Greenblatt, Samuel H.; Jackson, William T.

doi:10.1097/00007632-198803000-00003

Cited by 124 publications

(54 citation statements)

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“…Specifically, the technical errors made early in the series were: (1) screws placed in disc spaces and not in bone, and (2) plates spanning motion seg ments that had not been fused. Although the complication rate (25%) was similar to other studies that have reported results of this technique (Brown, 1988;Van Peteghem, 1979) (Table II), it is appreciably higher than the 6 to 10% rate of complications reported for posterior procedures (Rogers, 1957;Capen, 1985). However, we believe this anterior technique is indicated for compressive flexion injuries, as shown by Cabanela et al (1988).…”

Section: Discussionsupporting

confidence: 82%

“…Three subsequent studies of failed anterior interbody fusions demonstrated a high incidence of graft dislodgement and late kyphosis (Stauffer, 1977;Bohler, 1980;Van Peteghem, 1979), but in those studies, the grafts had either no or only minimal internal fixation. Use of current internal fixation has reduced the incidence of late graft dislodgement and kyphosis (de Oliveira, 1987;Brown, 1988;Cabanela, 1988).…”

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confidence: 99%

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Anterior plating of unstable cervical spine fractures

et al. 1990

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SummaryMedical records and radiographs of 16 patients who had anterior decompression, bone grafting, and plating of grade III and IV (Allen 1982) unstable cervical spine injuries were reviewed. Surgery was performed within 15 days of injury, reductions were achieved and maintained at follow-up, and fusion occurred in all cases. Neurologic func tion stabilised or improved in all cases. However, 3 patients (19%) had complications that necessitated additional surgery: one patient with undiagnosed non-contiguous post erior instability, and 2 patients for broken plates. These complications, in retrospect, could have been avoided.

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Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 99%

Anterior plating of unstable cervical spine fractures

et al. 1990

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“…The performance of anterior plating in this study corresponds to the clinical results in single-level corpectomy with fusion rates ranging 86-100%. Nevertheless, complication rates of 0-57% are reported [10,12,21,33,48,51,52], although a definite separation between single-level and multilevel results is not always feasible in these studies. Up to 20% hardware-related problems for anterior single-level procedures occur, such as hardware failure, graft extrusion and pseudarthrosis [13,15,17].…”

Section: Discussionmentioning

confidence: 91%

Effect of constrained posterior screw and rod systems for primary stability: Biomechanical in vitro comparison of various instrumentations in a single-level corpectomy model

et al. 2004

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Cervical corpectomy is a frequently used technique for a wide variety of spinal disorders. The most commonly used approach is anterior, either with or without plating. The results for single-level corpectomy are better than in multilevel procedures. Nevertheless, hardwareor graft-related complications are observed. In the past, constrained implant systems were developed and showed encouraging stability, especially for posterior screw and rod systems in the lumbar spine. In the cervical spine, few reports about the primary stability of constrained systems exist. Therefore, in the present study we evaluated the primary stability of posterior screw and rod systems, constrained and non-constrained, in comparison with anterior plating and circumferential instrumentations in a non-destructive set-up, by loading six human cadaver cervical spines with pure moments in a spine tester. Range of motion and neutral zone were measured for lateral bending, flexion/ extension and axial rotation.

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“…18,19 After multilevel anterior cervical corpectomy two out of 36 patients, 20 after anterior stabilization with combined plate and bone fusion two out of 13 patients suffered from dysphagia. 21 In the above-mentioned studies, the majority of patients underwent surgery for spondylotic cervical myelopathy. One study identified vocal fold paralysis in 5% of patients after cervical discectomy as a reason for dysphagia including aspiration.…”

Section: Dysphagia In Cscimentioning

confidence: 99%

Dysphagia in patients with acute cervical spinal cord injury

Wolf

Meiners

2003

Spinal Cord

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Study design: Longitudinal observational. Objectives: (a) To establish a reliable and feasible method to indicate the presence and severity of dysphagia and (b) to establish a course of treatment in individuals presenting with cervical spinal cord injury (CSCI). Setting: Spinal Cord Injury Center, Werner Wicker Klinik, Bad Wildungen, Germany. Patients and methods: This is a cross-sectional study of 51 patients consecutively admitted to the Intensive Care Unit of the SCI in-patient service. They were subjected to neurological and fiberoptic endoscopic examination of swallowing (FEES). Data concerning artificial respiration, presence of tracheostomy, oral or non-oral feeding were obtained from the medical charts. Statistics were carried out by a calculation of a nonparametric correlation (Spearman). Results: Five levels of dysphagia could be distinguished. At levels 1 and 2, patients presented with a severe impairment of swallowing, in level 3 aspiration was met by a powerful coughing reflex, level 4 comprised a laryngeal edema and/or a mild aspiration of fluids only and at level 5 laryngeal function was not compromised. On admission, 20 patients with CSCI presented with mild (level 4), eight with moderate (level 3) and 13 with severe dysphagia (levels 1 and 2). In 10 no signs of dysphagia could be detected. After treatment, level 1 was no longer detected, one patient showed level 2, two patients showed level 3, all other patients showed only mild or no signs of dysphagia any longer. Conclusions: Dysphagia of various severities was present in the majority of these patients with CSCI together with respiratory insufficiency. FEES allows for the detection and classification of dysphagia as well as for an evaluation of the therapeutic management. Under interdisciplinary treatment the prognosis of dysphagia is good.

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Cervical Stabilization by Plate and Bone Fusion

Cited by 124 publications

References 0 publications

Anterior plating of unstable cervical spine fractures

Anterior plating of unstable cervical spine fractures

Effect of constrained posterior screw and rod systems for primary stability: Biomechanical in vitro comparison of various instrumentations in a single-level corpectomy model

Dysphagia in patients with acute cervical spinal cord injury

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