Double-Plate Technique for Long-Construct Anterior Cervical Discectomy and Fusion

The standard technique for multilevel anterior cervical discectomy and fusion (ACDF) uses a single plate to span multiple vertebral levels. However, the usage of single long plates is linked to potential hardware failure and screw pullout from stress overload. A single long plate is also more likely to fail at the caudal levels. Furthermore, centering a long plate spanning multiple levels requires simultaneous exposure to anatomy that may require more traction, technical expertise, and a potential increase in operative time. The use of a double-plate technique may be less technically demanding and, at the same time, allow for future revision to be confined to a shorter segment rather than requiring the removal of the entire single plate. In this study, we describe a surgical technique that involves using two plates during three or more levels of ACDF, discussing its advantages and limitations.