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In vivo evaluation of biomechanical anterior cervical plate failure

Advances in Therapy volume 24, pages 415–426 (2007)Cite this article

Abstract

Anterior cervical plate (ACP) failure is rarely addressed in the literature. In this retrospective, observational, longitudinal, cohort study, the objectives were to (1) identify incidences of in vivo biomechanical failure in commercially available, US Food and Drug Administration-approved ACP systems, (2) describe modes of failure, (3) suggest structural explanations for system failure, and (4) discuss complications and treatment of patients with failed ACP systems. Investigators retrospectively identified patients who underwent anterior cervical procedures followed by use of ACP as a fusion adjunct and showed evidence of ACP failure on plain radiographs. Components of the ACP system that led to failure were identified and examined. A total of 240 patients received ACP supplementation of anterior cervical fusion constructs during the 9.5-y study period. Evidence of ACP failure was noted in 7 patients (3.3%), and an eighth patient was referred for evaluation after ACP failure. Screw-plate interface failure occurred in all 8 cases. The biomechanical method by which the bone screw head was secured into the vertebral body, or against the ACP, the use of hybrid systems, the surgical technique selected, and host factors were used to determine the rate of failure. Concern for esophageal or other tissue injury often necessitated ACP removal. Screw-plate interface failure, which was found to be the most common mode of biomechanical ACP failure, may occur in hybrid constructs and in systems that do not create a rigid interface between the screw head and the ACP. Surgical technique and patient host factors may also influence the rate of biomechanical construct failure.

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Affiliations

  1. Departments of Neurological Surgery and Orthopaedic Surgery, University of Pittsburgh School of Medicine and School for Rehabilitative Sciences and Technology, Pittsburgh, Pennsylvania

    William C. Welch MD, FACS, FICS, Joseph G. Ong MD, Peter C. Gerszten MD, MPH, Arthur P. Nestler RN, BSN, James P. Burke MD, PhD & Boyle C. Cheng PhD

Authors
  1. William C. Welch MD, FACS, FICS
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  2. Joseph G. Ong MD
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  3. Peter C. Gerszten MD, MPH
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  4. Arthur P. Nestler RN, BSN
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  5. James P. Burke MD, PhD
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  6. Boyle C. Cheng PhD
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Correspondence to William C. Welch MD, FACS, FICS.

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Welch, W.C., Ong, J.G., Gerszten, P.C. et al. In vivo evaluation of biomechanical anterior cervical plate failure. Adv Therapy 24, 415–426 (2007). https://doi.org/10.1007/BF02849911

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  • DOI: https://doi.org/10.1007/BF02849911

Keywords

  • anterior cervical plate
  • instrumentation failure
  • cervical fusion
  • constrained screws
  • arthrodesis