Anterior cervical plate fixation with the titanium hollow screw plate system

Although anterior cervical plates provide excellent fixation for the anterior column, the potential risk for injury to the spinal cord or soft tissues involved with their use has been the reason they have not gained universal acceptance. Morscher introduced a system that attempts to prevent the migration and loosening of screws by using a cross-split screw head that can be locked into the plate. The secondary advantage of this system is that it eliminates the requirement for posterior cortex purchase and thereby decreases the risk for spinal cord injury. This article reports the authors' experience using the Morscher titanium hollow screw cervical plate system. Forty-two patients in the series underwent anterior cervical arthrodesis for degenerative disease or trauma. The average number of levels fused were two. The fusion rate was 100%. Significant hardware loosening occurred in two patients. There was no iatrogenic injury to the spinal cord or esophagus. In conclusion, the titanium hollow screw cervical plate provides immediate stable fixation with minimal complications. Its use should be considered in the surgical treatment of patients requiring multilevel anterior cervical arthrodesis.