Osteosynthesis of the cervical spine with an anterior plate

Osteosynthesis of the cervical spine with an anterior plate is indicated for reconstruction by a bone graft after somatectomy and in anterior fusion for unstable lesions such as fracture dislocations and fractures with severe deformity. In these situations traditional surgery with intersomatic wedged bone grafts may be insufficient and posterior surgery inadequate or risky. The authors report 11 cases of anterior osteosynthesis with a Louis plate, all of which were sufficiently stable to allow early mobilisation and minimal external orthosis. Fusion of the grafts occurred in all cases at long-term follow-up. The method involves a potential risk to the esophagus, which is in close contact with the plate. It must therefore be limited to cases in which the advantages outweigh the risks. The indications, technique, complications and results are discussed.