gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Fusion and failure following anterior cervical plating with dynamic or rigid plates: 2-year results of a multi-centric, prospective, randomized, controlled study

Fusions- und Versagensquote nach ventraler zervikaler Plattenfixierung mit dynamischen und rigiden Platten: 2-Jahres Ergebnisse einer multizentrischen, randomisierten, kontrollierten Studie

Meeting Abstract

  • corresponding author T. Pitzen - Neurochirurgische Klinik, Universitätsklinikum Homburg
  • J. Chrobok - Neurosurgery, Homolka Hospital, Praha
  • J. Stulik - Spinal Surgery, University Hospital Motol, Praha
  • S. Ruffing - Radiologie, Knappschaftsklinik Püttlingen
  • L. Sova - Neurochirurgische Abteilung, Bundeswehrkrankenhaus Ulm
  • J. Drumm - Neurochirurgische Klinik, Universitätsklinikum Homburg
  • R. Kucera - Neurosurgery, Homolka Hospital, Praha
  • T. Vyscocil - Spinal Surgery, University Hospital Motol, Praha
  • W. I. Steudel - Neurochirurgische Klinik, Universitätsklinikum Homburg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSA.07.02

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

Published: April 11, 2007

© 2007 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 a treated 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. This may result 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 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, Aesculap) or a rigid plate (CSLP, Synthes). After surgery, three and six months postoperatively and after two years, we looked at segmental mobility and implant complications. All measurements were performed by an independent radiologist. Please note, that six-month results of the current study have been presented on last years meeting. We can now present the 2-year results. Six-month mobility results are available for 77 patients (43 ABC / 34 CSLP), two year results for 37 patients (22 ABC, 15 CSLP).

Results: Mean segmental mobility after surgery for the ABC-group was 1.7 mm, 1.4 mm after three months, 0.8 mm after six months, 0.5 mm after two years. For the CSLP-group these values were 1.0 mm, 1.8 mm, 1.7 mm and 0.3 mm. The difference at six months between both groups is significant (p=0.02), however is not significant after two years (p=0.91). There have been 4 patients with hardware complications within the CSLP-group and no implant complications within the ABC-group, p=0.044.

Conclusions: There is still 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. The two-year results confirm our earlier findings.