Anterior cervical discectomy and fusion with a dynamic translational plating versus a rigid carbon fiber reinforced PEEK plating system - a comparison study of radiographic parameters

Purpose In this study the authors compare the radiographic findings of patients undergoing 1-3 level ACDF a rigid CFRP plate and a translational titanium plate system with a focus on radiographic alignment. Material and Methods A retrospective review 70 consecutive patients undergoing a 1 to 3 level ACDF for cervical spondylosis was conducted. 2 groups depending on the cervical plating system were created including 38 patients in group 1 (dynamic plate) and 32 in group 2 (rigid CFRP plate). Plain neutral radiographs preoperatively, immediately after surgery and at most recent follow-up were used to assess parameters on sagittal alignment, fusion height, adjacent segment ossification (ASO), fusion rate and implant failure. Results There were no significant differences between groups preoperatively. Both groups had a more than 12 months follow-up (p = 0.327). Improvement of C2-7 lordosis was seen in both groups but only in group 1 it reached statistical significance at final follow-up. Significant improvement in sagittal segmental alignment was noted in both groups following surgery. A significant sagittal correction of 5.5 +/- 9.1 degrees (p = 0.002) was maintained through follow-up only in group 2. No significantly different was seen for segmental fusion rates and loss of fusion height. There were no instances of implant failure within both groups. Worsening of ASO was 20% for both groups. Conclusion ACDF allows for correction and maintenance of cervical alignment. Rigid rigid plate appears more effective at maintaining segmental lordotic correction. The fusion rate and implant failure was not different for both groups.