Study on Early Effects of Vectra-T Dynamic Plate for Cervical Spondylosis_Chinese Journal of Evidence-Based Medicine

Authors：

 WUWen-jie ,  LIUHao , HONGYing , GONGQuan , LITao , LIULi-min , SONGYue-ming

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LIUHao, Email: liuhao6304@163.com

Keywords：

Cervical spondylosis; Vertebral body subtotal resection; Cervical spine fusion; Vectra-T dynamic plate; Titanium mesh

DOI：

10.7507/1672-2531.20140191

Video：

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Objective To study the efficacy of anterior cervical Vectra-t dynamic plate and titanium mesh for cervical spondylosis. Methods A retrospectively analysis involving 20 cases (44 sections) from June 2010 to October 2012 was performed in the department of orthopaedic in the West China Hospital of Sichuan University. All patients received the operation of anterior cervical vertebral resection decompression, titanium mesh and bone graft, and Vectra-T plate. The data of the JOA scores, cervical curvature, the conditions of vertebral body fusion after bone graft and the situation of titanium mesh subsidence were all collected. Statistical analysis were performed using SPSS 19.0 software. Results a) All the 20 cases received a 12-to 30-month follow-up. The results of statistical analysis showed that:the JOA scores were as follows:7.68±1.66 for preoperative, 10.91±1.97 for after surgery and 12.74±1.27 for the endpoint of follow-up, and significant differences were found between these scores (P < 0.05). b) There was no loose of screw or plate. The local cervical angle and regional cervical angle were improved after surgery. In the 44 segments of fusion, 43 segments fused within 6 months, one of the segment delayed to fuse 12 months after surgery. c) The subsidence of titanium mesh were 2.7±2.7 mm on average in 3 months after surgery, 3.6±1.0 mm on average in 6 months after surgery, 3.9±1.2 mm on average in 12 months after surgery and 4.0±1.2 mm on average in last follow-up. Titanium mesh subsidence mainly concentrated in the postoperative period of 6 months. After six months of titanium mesh subsidence was no longer apparent. Conclusion The application of Vectra-T dynamic plate can effectively improve the curvature of the cerical sagittal position, prevent protrusion deformity, reduce the related complications after bone graft, effectively avoid the stress shelter in the static plate, andspromote the fusion between the cervical vertebral bodies. However, the long-term curative effects are still needed to be assessed by large sample randomized controlled trials with long-term follow-up.

Citation： WUWen-jie, LIUHao, HONGYing, GONGQuan, LITao, LIULi-min, SONGYue-ming. Study on Early Effects of Vectra-T Dynamic Plate for Cervical Spondylosis. Chinese Journal of Evidence-Based Medicine, 2014, 14(10): 1185-1189. doi: 10.7507/1672-2531.20140191 Copy

1.	Bohler J, Gauderank T. Anterior plate stabilization for fracture-dislocations of the lower cervical spine. J Trauma Acute Care, 1980, 20(3):203-205.
2.	Caspar W, Barbier D, Klara PM. Anterior cervical fusion and Caspar plate stabilization for cervical trauma. Neurosurgery, 1989, 25(4):491-502.
3.	Liu JK, Apfelbaum RI, Schmidt MH. Surgical management of cervical spinal metastasis:anterior reconstruction and stabilization techniques. Neurosurg Clin N Am, 2004, 15(4):413-424.
4.	Mayr MT, Subach BR, Comey CH, et al. Cervical spinal stenosis:outcome after anterior corpectomy, allograft reconstruction, and instrumentation. J Neurosurg-Spine, 2002, 96(1):10-16.
5.	Winn RH. Youmans neurological surgery. New York:WB Saunders, 2004.
6.	Nakase H, Tamaki R, Matsuda R, et al. Delayed reconstruction by titanium mesh-bone graft composite in pyogenic spinal infection:a long-term follow-up study. J Spinal Disord Tech, 2006, 19(1):48-54.
7.	Dorai Z, Morgan H, Coimbra C. Titanium cage reconstruction after cervical corpectomy. J Neurosurg-Spine, 2003, 99(1):3-7.
8.	Chung DY, Cho DC, Lee SH, et al. Preliminary surgical result of cervical spine reconstruction with a dynamic plate and titanium mesh cage. J Korean Neurosurg S, 2007, 41:111-117.
9.	Thalgott JS, Xiongsheng C, Giuffre JM. Single stage anterior cervical reconstruction with titanium mesh cages, local bone graft, and anterior plating. Spine J, 2003, 3(4):294-300.
10.	Stulik J, Pitzen TR, Chrobok J, et al. Fusion and failure following anterior cervical plating with dynamic or rigid plates:6-months results of a multi-centric, prospective, randomized, controlled study. Eur Spine J, 2007, 16(10):1689-1694.
11.	Ghahreman A, Rao PJV, Ferch RD. Dynamic plates in anterior cervical fusion surgery:graft settling and cervical alignment. Spine, 2009, 34(15):1567-1571.
12.	Brodke DS, Gollogly S, Mohr RA, et al. Dynamic cervical plates:biomechanical evaluation of load sharing and stiffness. Spine, 2001, 26(12):1324-1329.
13.	Epstein NE. The management of one-level anterior cervical corpectomy with fusion using Atlantis hybrid plates:preliminary experience. J Spinal Disord Tech, 2000, 13(4):324-328.
14.	孔金海, 吕国华, 康意军, 等.颈前路钛网植骨融合术后钛网沉陷的原因探讨.中国脊柱脊髓杂志, 2007, 17(2):98-102.
15.	Lee SH, Sung JK. Anterior cervical stabilization using a semi-constrained cervical plate and titanium mesh cage for single level corpectomy. J CLin Neurosci, 2008, 15(11):1227-1234.
16.	Narotam PK, Pauley SM, McGinn GJ. Titanium mesh cages for cervical spine stabilization after corpectomy:a clinical and radiological study. J Neurosurg-Spine, 2003, 99(2):172-180.
17.	Balabhadra RSV, Kim DH, Zhang HY. Anterior cervical fusion using dense cancellous allografts and dynamic plating. Neurosurgery, 2004, 54(6):1405-1412.
18.	Johnson MG, Fisher CG, Boyd M, et al. The radiographic failure of single segment anterior cervical plate fixation in traumatic cervical flexion distraction injuries. Spine, 2004, 29(24):2815-2820.
19.	DuBois CM, Bolt PM, Todd AG, et al. Static versus dynamic plating for multilevel anterior cervical discectomy and fusion. Spine J, 2007, 7(2):188-193.
20.	Samartzis D, Shen FH, Matthews DK, et al. Comparison of allograft to autograft in multilevelanterior cervical discectomy and fusion with rigid plate fixation. Spine J, 2003, 3(6):451-459.
21.	Hong SW, Lee SH, Khoo LT, et al. A comparison of fixed-hole and slotted-hole dynamic plates for anterior cervical discectomy and fusion. J Spinal Disord Tech, 2010, 23(1):22-26.
22.	Goldberg G, Albert TJ, Vaccaro AR, et al. Short-term comparison of cervical fusion with static and dynamic plating using computerized motion analysis. Spine, 2007, 32(13):E371-E375.
23.	Brodke DS, Gollogly S, Mohr RA, et al. Dynamic cervical plates:biomechanical evaluation of load sharing and stiffness. Spine, 2001, 26(12):1324-1329.
24.	Brodke DS, KlimoJr P, Bachus KN, et al. Anterior cervical fixation:analysis of load-sharing and stability with use of static and dynamic plates. J Bone Joint Surg Br, 2006, 88(7):1566-1573.
25.	Stulik J, Pitzen R, Chrobok J, et al. Fusion and failure following anterior cervical plating with dynamic or rigid plates:6-months results of a multi-centric, prospective, randomized, controlled study. Eur Spine J, 2007, 16(10):1689-1694.
26.	Nunley PD, Jawahar A, Kerr ⅢEJ, et al. Choice of plate may affect outcomes for single versus multilevel ACDF:results of a prospective randomized single-blind trial. Spine J, 2009, 9(2):121-127.
27.	Epstein NE. Anterior dynamic plates in complex cervical reconstructive surgeries. J Spinal Disord Tech, 2002, 15(3):221-227.
28.	王柏川, 王闵, 樊仕才.人体中, 下段颈椎曲率的测量及意义.中国临床解剖学杂志, 2001, 19(2):179-181.
29.	Mohr RA, Brodke DS. Fixed versus dynamic cervical plates:how to choose the proper plate. Curr Opin Orthop, 2005, 16(3):194-199.
30.	Gercek E, Arlet V, Delisle J, et al. Subsidence of stand-alone cervical cages in anterior interbody fusion:warning. Eur Spine J, 2003, 12(5):513-516.
31.	Kanayama M, Hashimoto T, Shigenobu K, et al. Pitfalls of anterior cervical fusion using titanium mesh and local autograft. J Spinal Disord Tech, 2003, 16(6):513-518.
32.	van Jonbergen HPW, Spruit M, Anderson PG, et al. Anterior cervical interbody fusion with a titanium box cage:early radiological assessment of fusion and subsidence. Spine J, 2005, 5(6):645-649.
33.	Hasegawa K, Abe M, Washio T, et al. An experimental study on the interface strength between titanium mesh cage and vertebra in reference to vertebral bone mineral density. Spine, 2001, 26(8):957-963.
34.	Daubs MD. Early failures following cervical corpectomy reconstruction with titanium mesh cages and anterior plating. Spine, 2005, 30(12):1402-1406.

1. Bohler J, Gauderank T. Anterior plate stabilization for fracture-dislocations of the lower cervical spine. J Trauma Acute Care, 1980, 20(3):203-205.
2. Caspar W, Barbier D, Klara PM. Anterior cervical fusion and Caspar plate stabilization for cervical trauma. Neurosurgery, 1989, 25(4):491-502.
3. Liu JK, Apfelbaum RI, Schmidt MH. Surgical management of cervical spinal metastasis:anterior reconstruction and stabilization techniques. Neurosurg Clin N Am, 2004, 15(4):413-424.
4. Mayr MT, Subach BR, Comey CH, et al. Cervical spinal stenosis:outcome after anterior corpectomy, allograft reconstruction, and instrumentation. J Neurosurg-Spine, 2002, 96(1):10-16.
5. Winn RH. Youmans neurological surgery. New York:WB Saunders, 2004.
6. Nakase H, Tamaki R, Matsuda R, et al. Delayed reconstruction by titanium mesh-bone graft composite in pyogenic spinal infection:a long-term follow-up study. J Spinal Disord Tech, 2006, 19(1):48-54.
7. Dorai Z, Morgan H, Coimbra C. Titanium cage reconstruction after cervical corpectomy. J Neurosurg-Spine, 2003, 99(1):3-7.
8. Chung DY, Cho DC, Lee SH, et al. Preliminary surgical result of cervical spine reconstruction with a dynamic plate and titanium mesh cage. J Korean Neurosurg S, 2007, 41:111-117.
9. Thalgott JS, Xiongsheng C, Giuffre JM. Single stage anterior cervical reconstruction with titanium mesh cages, local bone graft, and anterior plating. Spine J, 2003, 3(4):294-300.
10. Stulik J, Pitzen TR, Chrobok J, et al. Fusion and failure following anterior cervical plating with dynamic or rigid plates:6-months results of a multi-centric, prospective, randomized, controlled study. Eur Spine J, 2007, 16(10):1689-1694.
11. Ghahreman A, Rao PJV, Ferch RD. Dynamic plates in anterior cervical fusion surgery:graft settling and cervical alignment. Spine, 2009, 34(15):1567-1571.
12. Brodke DS, Gollogly S, Mohr RA, et al. Dynamic cervical plates:biomechanical evaluation of load sharing and stiffness. Spine, 2001, 26(12):1324-1329.
13. Epstein NE. The management of one-level anterior cervical corpectomy with fusion using Atlantis hybrid plates:preliminary experience. J Spinal Disord Tech, 2000, 13(4):324-328.
14. 孔金海, 吕国华, 康意军, 等.颈前路钛网植骨融合术后钛网沉陷的原因探讨.中国脊柱脊髓杂志, 2007, 17(2):98-102.
15. Lee SH, Sung JK. Anterior cervical stabilization using a semi-constrained cervical plate and titanium mesh cage for single level corpectomy. J CLin Neurosci, 2008, 15(11):1227-1234.
16. Narotam PK, Pauley SM, McGinn GJ. Titanium mesh cages for cervical spine stabilization after corpectomy:a clinical and radiological study. J Neurosurg-Spine, 2003, 99(2):172-180.
17. Balabhadra RSV, Kim DH, Zhang HY. Anterior cervical fusion using dense cancellous allografts and dynamic plating. Neurosurgery, 2004, 54(6):1405-1412.
18. Johnson MG, Fisher CG, Boyd M, et al. The radiographic failure of single segment anterior cervical plate fixation in traumatic cervical flexion distraction injuries. Spine, 2004, 29(24):2815-2820.
19. DuBois CM, Bolt PM, Todd AG, et al. Static versus dynamic plating for multilevel anterior cervical discectomy and fusion. Spine J, 2007, 7(2):188-193.
20. Samartzis D, Shen FH, Matthews DK, et al. Comparison of allograft to autograft in multilevelanterior cervical discectomy and fusion with rigid plate fixation. Spine J, 2003, 3(6):451-459.
21. Hong SW, Lee SH, Khoo LT, et al. A comparison of fixed-hole and slotted-hole dynamic plates for anterior cervical discectomy and fusion. J Spinal Disord Tech, 2010, 23(1):22-26.
22. Goldberg G, Albert TJ, Vaccaro AR, et al. Short-term comparison of cervical fusion with static and dynamic plating using computerized motion analysis. Spine, 2007, 32(13):E371-E375.
23. Brodke DS, Gollogly S, Mohr RA, et al. Dynamic cervical plates:biomechanical evaluation of load sharing and stiffness. Spine, 2001, 26(12):1324-1329.
24. Brodke DS, KlimoJr P, Bachus KN, et al. Anterior cervical fixation:analysis of load-sharing and stability with use of static and dynamic plates. J Bone Joint Surg Br, 2006, 88(7):1566-1573.
25. Stulik J, Pitzen R, Chrobok J, et al. Fusion and failure following anterior cervical plating with dynamic or rigid plates:6-months results of a multi-centric, prospective, randomized, controlled study. Eur Spine J, 2007, 16(10):1689-1694.
26. Nunley PD, Jawahar A, Kerr ⅢEJ, et al. Choice of plate may affect outcomes for single versus multilevel ACDF:results of a prospective randomized single-blind trial. Spine J, 2009, 9(2):121-127.
27. Epstein NE. Anterior dynamic plates in complex cervical reconstructive surgeries. J Spinal Disord Tech, 2002, 15(3):221-227.
28. 王柏川, 王闵, 樊仕才.人体中, 下段颈椎曲率的测量及意义.中国临床解剖学杂志, 2001, 19(2):179-181.
29. Mohr RA, Brodke DS. Fixed versus dynamic cervical plates:how to choose the proper plate. Curr Opin Orthop, 2005, 16(3):194-199.
30. Gercek E, Arlet V, Delisle J, et al. Subsidence of stand-alone cervical cages in anterior interbody fusion:warning. Eur Spine J, 2003, 12(5):513-516.
31. Kanayama M, Hashimoto T, Shigenobu K, et al. Pitfalls of anterior cervical fusion using titanium mesh and local autograft. J Spinal Disord Tech, 2003, 16(6):513-518.
32. van Jonbergen HPW, Spruit M, Anderson PG, et al. Anterior cervical interbody fusion with a titanium box cage:early radiological assessment of fusion and subsidence. Spine J, 2005, 5(6):645-649.
33. Hasegawa K, Abe M, Washio T, et al. An experimental study on the interface strength between titanium mesh cage and vertebra in reference to vertebral bone mineral density. Spine, 2001, 26(8):957-963.
34. Daubs MD. Early failures following cervical corpectomy reconstruction with titanium mesh cages and anterior plating. Spine, 2005, 30(12):1402-1406.

Chinese Journal of Evidence-Based Medicine

Study on Early Effects of Vectra-T Dynamic Plate for Cervical Spondylosis

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