gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Fusion rate and failure rate following anterior cervical plating with dynamic or rigid plates: Results of a multi-centric, prospective, randomized, controlled study

Fusions- und Versagensraten nach ventraler zervikaler Plattenosteosynthese bei dynamischen und rigiden Platte: Ergebnisse einer multizentrischen, prospektiven, randomisierten, kontrollierten Studie

Meeting Abstract

  • corresponding author T. Pitzen - Neurochirurgische Klinik, Universitätskliniken des Saarlandes, Homburg
  • S. Ruffing - Abteilung für Radiologie, Bundesknappschaftsklink Püttlingen, Püttlingen
  • J. Chrobok - Neurosurgical Department, Nemocnice na Homolce, Praha, Czech Republic
  • J. Stulik - Department of Spondylsurgery, Hospital Motol, Praha, Czech Republic
  • J. Drumm - Neurochirurgische Klinik, Universitätskliniken des Saarlandes, Homburg
  • W. I. Steudel - Neurochirurgische Klinik, Universitätskliniken des Saarlandes, Homburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocFR.02.03

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Pitzen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Anterior cervical plate fixation is an approved technique for cervical spine stabilization in the presence of anterior cervical instability. Rigid plate designs, in which the screws are locked to the plate, are in common use and thought to provide more fixation to an injured segment than dynamic designs, in which the screws may glide when the graft is settling. Recently, mechanical studies gave evidence, that dynamic anterior plates provide more loading on the graft thus resulting in a more rapid fusion and – as a consequence - lower implant complications. This, however, must not be necessarily true under in vivo conditions. Thus, the objective of the study was to analyse speed of fusion and implant complications in both type of plates.

Methods: This is a prospective, randomized, controlled multi-centric study, approved by the competent ethic committees of each participating country. 132 patients were included and assigned by randomisation to one of the groups in which they received a routine anterior cervical discectomy and autograft fusion with either a dynamic plate with screws locked in ap – direction (ABC) or a rigid plate (CSLP). After 3 and 6 months (mos), we looked at the following radiographic data: segmental mobility and implant complications or failed fusion, respectively. All measurements were performed by an independent radiologist.

Results: 6 mos mobility results were available for 71 patients (39 ABC / 32 CSLP). Baseline (immediately postop or at discharge) mean segmental motility for the ABC group was 1,67 mm, 1,37 mm after 3 mos and 0,5 mm after 6 mos. For the CSLP- group these values were 0,95 mm, 1,9 mm and 1,88 mm. The difference at 6 mos between both groups is significant (p=0,009). There have been 4 patients with hardware complications within the CSLP – group (n=41) and no implant complications within the ABC – group (n=45), p=0.048, Fisher’s Exact test.

Conclusions: There is evidence, that dynamic plate designs provide a more rapid fusion in cervical spine surgery than rigid plate designs. Moreover, the rate of implant complications tends to be lower in this group. To date, these interim results are just true for the 6-mos follow-up period.