Misaligned Versus Straight Placement of Anterior Cervical Plates: A Clinical and Radiologic Outcomes Study, JAAOS

Misaligned Versus Straight Placement of Anterior Cervical Plates: A Clinical and Radiologic Outcomes Study, JAAOS, Dr. Kingsley R. Chin

Misaligned Versus Straight Placement of Anterior Cervical Plates: A Clinical and Radiologic Outcomes Study, JAAOS

Scientific Paper

Chin KR1, Pencle FJFrancis SDFrancis CASeale JAHothem EA. J Am Acad Orthop Surg 2017

Interested medical professionals can read through the full paper, published in the Journal of the American Academy of Orthopaedic Surgeonshere.

Background

In anterior cervical diskectomy and fusion (ACDF), misaligned plates are concerning because of the risk of screw-and-plate failure; however, these plates also hypothetically have the potential for asymmetric micromotion on the facet and uncovertebral joint. The aim of this study was to determine whether misaligned plate placement during ACDF had clinical benefits compared with straight plate placement.

Methods

Postoperative AP radiographs of 128 consecutive patients who underwent ACDF with anterior cervical plate (ACP) fixation were reviewed, and plate alignment was assessed. Patients were separated into control group 1 (straight plates) or group 2 (misaligned plates).

Results

The mean age of patients was 51.5 ± 0.9 years, and women represented 51% of the total population. There was no significant difference between groups with regard to the preoperative visual analog scale (VAS) and Neck Disability Index (NDI) scores (P = 0.744 and P = 0.943, respectively). At 6 weeks postoperatively, the VAS scores for group 1 decreased from 7.6 ± 0.2 to 4.0 ± 0.2 compared with the scores in group 2, which decreased from 7.7 ± 0.2 to 2.1 ± 0.1, which demonstrated statistical significance (P = 0.019). At 2-year follow-up, no significant difference was demonstrated between the groups’ VAS and NDI scores (P = 0.670 and P = 0.266).

Misaligned Versus Straight Placement of Anterior Cervical Plates: A Clinical and Radiologic Outcomes Study, JAAOS, Dr. Kingsley R. Chin

Straight placement

Misaligned Versus Straight Placement of Anterior Cervical Plates: A Clinical and Radiologic Outcomes Study, JAAOS, Dr. Kingsley R. Chin

Misaligned placement

Conclusion 

Misaligned plates have increased torsional strength and are associated with better clinical outcomes compared with those of straight plates in the early postoperative period. After fusion, no significant difference in clinical outcomes between the groups was noted, which may reduce the concerns regarding misaligned plates.

Level of Evidence

Retrospective comparative study.

About Author Dr. Kingsley R. Chin
Misaligned Versus Straight Placement of Anterior Cervical Plates: A Clinical and Radiologic Outcomes Study Dr. Kingsley R. Chin

Dr. Kingsley R. Chin, founder of philosophy and practice of The LES Society and The LESS Institute

Dr. Kingsley R. Chin is a board-certified Harvard-trained orthopedic spine surgeon and professor with copious business and information technology experience. He sees a niche opportunity where medicine, business and information technology meet and is uniquely experienced at the intersection of these three professions. He currently serves as Professor of Clinical and Biomedical Sciences at the Charles E. Schmidt School of Medicine at Florida Atlantic University and Professor of Clinical Orthopaedic Surgery at the Herbert Wertheim College of Medicine at Florida International University and has experience as Assistant Professor of Orthopaedics at the University of Pennsylvania Medical School and Visiting Professor at the University of the West Indies.

Learn more about Dr. Chin here and connect via LinkedIn.

ABOUT LESS EXPOSURE SURGERY

Less Exposure Surgery (LES) is based on a new philosophy of performing surgery, leading the charge to prove through bench and clinical outcomes research that LES treatment options are the best solutions – to lowering the cost of healthcare, improving outcomes and increasing patient satisfaction. Learn more at LESSociety.org.

The LES Society philosophy: “Tailor treatment to the individual aiding in the quickest recovery and return to a pain-free lifestyle, using LES® techniques that lessen exposure, preserve unoffending anatomy and utilize new technologies which are safe, easy to adopt and reproducible. These LES®techniques lessen blood loss, surgical time and exposure to radiation and can be safely performed in an outpatient center. Less is more.” – Kingsley R. Chin, MD

ABOUT THE LESS INSTITUTE

The LESS Institute is the world leader center of excellence in Less Exposure Surgery. Our safe, effective outpatient treatments help patients recover quickly, avoid expensive hospital stays and return home to their family the same day. Watch our patient stories, follow us on Facebook and visit TheLESSInstitute.com to learn more.

ABOUT SPINEFRONTIER

The above study utilized Inset® LES Technology from SpineFrontier – leading provider of LES Technologies and instruments – offering surgeons and patients superior technology and services.

SCIENTIFIC PAPER AUTHOR AND CITATION DETAILS

Chin KR, et al. J Am Acad Orthop Surg. 2017

Authors

Chin KR1, Pencle FJ, Francis SD, Francis CA, Seale JA, Hothem EA.

Author information

  • 1From the Department of Clinical and Biomedical Sciences, Florida Atlantic University, Boca Raton, FL, the Department of Orthopedics, Florida International University, Miami, FL (Dr. Chin), and the LESS Institute, Miami (Dr. Chin, Dr. Pencle, Ms. S. Francis, Ms. C. Francis, Dr. Seale, and Dr. Hothem).

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