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Systematic review of the effect of dynamic fixation systems compared with rigid fixation in the anterior cervical spine

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  • Published:
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Abstract

Purpose

Anterior cervical fixation is a procedure widely employed in medical practice, with different fixation systems in use. This study aimed to perform a systematic review of the literature comparing the use of rigid and dynamic cervical plates regarding the fusion rate and complications.

Methods

A search was conducted in PubMed, Lilacs, and Cochrane databases and selecting comparative studies on the use of rigid and dynamic cervical plates. Prospective randomized studies were selected to describe the final results regarding the clinical and radiological outcomes; comparative observational studies were also cited. Complications of using the dynamic cervical plate were also evaluated.

Results

Seven comparative studies were included in the review. Five of these were prospective and randomized studies that did not report significant differences in the clinical outcome. One study reported a faster fusion rate when dynamic cervical plate was used, and another study showed a higher fusion rate when a dynamic cervical plate was applied on multiple levels. Four studies investigated the complications of using a dynamic plate and reported that changes in the cervical curvature angle and material failure were the most frequent complications.

Conclusions

There were no clinical differences between the two types of cervical fixation systems. A difference in the fusion rates could not be found at any follow-up time or in any of the studies. There was a loss of lordotic correction in the dynamic systems and a higher rate of complications in patients with a loss of lordotic correction.

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Conflict of interest

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Author information

Authors and Affiliations

  1. Division of Spine Surgery, Hospital do Servidor Público do Estado de São Paulo-SP, Rua Serra de Bragança, 953, 113A, São Paulo, SP, 03318-000, Brazil

    Ricardo Rezende Campos & Ricardo Vieira Botelho

Authors
  1. Ricardo Rezende Campos
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  2. Ricardo Vieira Botelho
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Corresponding author

Correspondence to Ricardo Rezende Campos.

Appendices

Appendix 1

Search protocol to comparative studies among rigid plate and dynamic plate

MedLine search:

  • #1. “Cervical spine” [All Fields] AND (dynamic[All Fields] OR semirigid[All Fields]) AND ((fixation[All Fields] OR (“instrumentation”[Subheading] OR “instrumentation”[All Fields]))).

  • #2-((“spinal cord compression”[MeSH Terms] OR (“spinal”[All Fields] AND “cord”[All Fields] AND “compression”[All Fields]) OR “spinal cord compression”[All Fields]) OR (“arthrodesis”[MeSH Terms] OR “arthrodesis”[All Fields])) AND (dynamic[All Fields] OR static[All Fields]) AND (anterior[All Fields] AND fixation[All Fields]) AND (“neck”[MeSH Terms] OR “neck”[All Fields] OR “cervical”[All Fields]).

  • #3-(spinal cord disease OR arthrodesis) (dynamic OR static) AND (anterior fixation) AND cervical.

.

Central Cochrane de Ensaios Randomizados

# Cervical spine AND dynamic plate.

Lilacs:

  • # Cervical spine.

  • # Cervical spine AND plate.

  • # Cervical spine AND randomized.

  • # Cervical spine AND dynamic plate.

Appendix 2

Search protocol for complications

Medline:

(“Cervical vertebrae”[MeSH Terms] OR (“cervical”[All Fields] AND “vertebrae”[All Fields]) OR “cervical vertebrae”[All Fields] OR (“cervical”[All Fields] AND “spine”[All Fields]) OR “cervical spine”[All Fields]) AND ((dynamic[All Fields] AND fixation[All Fields]) OR (dynamic[All Fields] AND (“bone plates”[MeSH Terms] OR (“bone”[All Fields] AND “plates”[All Fields]) OR “bone plates”[All Fields] OR “plate”[All Fields]))) AND (complication[All Fields] OR (“risk”[MeSH Terms] OR “risk”[All Fields]) OR damage[All Fields] OR harm[All Fields]).

Central Cochrane:

Cervical spine AND complications AND dynamic plate.

Lilacs:

  • Cervical spine AND complications AND dynamic plate.

  • Cervical spine AND complications.

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Campos, R.R., Botelho, R.V. Systematic review of the effect of dynamic fixation systems compared with rigid fixation in the anterior cervical spine. Eur Spine J 23, 298–304 (2014). https://doi.org/10.1007/s00586-013-3039-3

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  • DOI: https://doi.org/10.1007/s00586-013-3039-3

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