Loss of Lordosis and Clinical Outcomes after Anterior Cervical Fusion with Dynamic Rotational Plates

• Published in: Yonsei medical journal Vol. 54; no. 3; pp. 726 - 731
• Main Authors: Lee, Jin-Young, Park, Moon Soo, Moon, Seong-Hwan, Shin, Jae-Hyuk, Kim, Seok Woo, Kim, Yong-Chan, Lee, Seong Jin, Suh, Bo-Kyung, Lee, Hwan-Mo
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.05.2013; 연세대학교의과대학
• Subjects: Adult; Aged; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - surgery; Female; Humans; Male; Middle Aged; Original; Radiography; Spinal Fusion - adverse effects; Spinal Fusion - instrumentation; Treatment Outcome; 의학일반; Cervical alignment; subsidence; cervical fusion; dynamic rotational cervical plates
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2013.54.3.726

The cervical dynamic rotational plating system may induce bone graft subsidence, so it may cause loss of cervical lordosis. However there were few studies for alignments of cervical spines influencing the clinical results after using dynamic rotational plates. The purpose is to evaluate the effect of graft subsidence on cervical alignments due to the dynamic rotational cervical plates and correlating it with the clinical outcomes of patients undergoing anterior cervical fusion. Thirty-three patients with disease or fracture underwent anterior cervical decompression and fusion using a dynamic rotational plate. The presence and extent of implant complications, graft subsidence, loss of lordosis were identified and Visual Analog Scale score (VAS score), Japanese Orthopaedic Association score (JOA score), clinical outcomes based on Odom's criteria were recorded. Fusion was achieved without implant complications in all cases. The mean graft subsidence at 6 months after the surgery was 1.46 mm. The lordotic changes in local cervical angles were 5.85° which was obtained postoperatively. VAS score for radicular pain was improved by 5.19 and the JOA score was improved by 3. Clinical outcomes based on Odom's criteria showed sixteen excellent, ten good and two satisfactory results. There was no significant relationship between clinical outcomes and changes in the cervical angles. Dynamic rotational anterior cervical plating provides comparable clinical outcomes to that of the reports of former static cervical platings. The loss of lordosis is related to the amount of graft settling but it is not related to the clinical outcomes.