Anterior dynamic plates in complex cervical reconstructive surgeries

The aim of this work was to evaluate the efficacy of dynamic anterior cervical plates following one-level anterior corpectomy with fusion (ACF) (i.e., C5-7) and two- to four-level ACF with posterior wiring and fusion (PWF). Dynamic plates (ABC Aesculap, Tuttlingen, Germany), allowing for 10 mm of cephalad and 10 mm of caudad plate migration, were applied for one-level ACF (28 patients) and multilevel ACF/PWF (20 patients). Two (7%) dynamic plates failed after one-level ACF. One pseudarthrosis and one plate extrusion occurred, both in morbidly obese patients. No multilevel ACF/PWF failed. The 7% failure rate for dynamic plates applied for one-level ACF is somewhat high, whereas the 0% failure rate for multilevel ACF/PWF with halo immobilization proves more promising. Perhaps PWF with halo stabilization for morbidly obese individuals undergoing one-level ACF would avoid future plate-related problems.