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  • Anterior cervical discectomy and fusion using Single Screw Plate with artificial graft compared to Conventional Double Screw Plate with allograft.

    Final Number:

    Gentian Toshkezi MD; Raed Moustafa; Keith G. Davies MD, MBBS, FRCS; Lawrence S. Chin MD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: The aim of this study is to compare the outcome of fusion rate and the complications of using single screw plate (SSP)to the conventional double screw plate (CDSP).

    Methods: This is a retrospective study of 112 patients undergoing 1,2 and 3 level ACDF from 2/2007 to 5/2011. The single screw plate(SSP)group consists of 78 patients. The other group of 34 patient used conventional double screw plate (CDSP) with 100% using allograft. The mean duration of follow up is 30 months for both groups.

    Results: Presenting symptoms in SSP group were 32% related to myelopathy, 59% to radiculopathy, and 9 % both radiculo-myelopathy. In the CDSP group presenting symptoms were 35% related to myelopathy, 50% related to radiculopathy and 15 % to myelo-radiculopathy. 82% of the SSP group had 1 level surgery and, 18% 2 levels. In the CDSP group 41% had 1 level surgery, 47% two levels and 12% three levels surgery. Cervical collar was worn post-op for 6 weeks in 27% of SSP group versus 94% of CDSP group. In post-op complication transient dysphagia was present 4% in SSP group versus 9% in CDSP group. Reoperation for adjacent level disc degneration was 1.28% in SSP group versus 2.94 in the CDSP group; surgical site hematoma 1.28% in SSP group. Incidental CSF leak was in 5.88%in the CDSP group. None of the patients from the SSP group had evidence of hardware failure compared to 3% of CDSP group based on radiographic findings. Resolution of the pre-op symptoms in SSP group was complete in 64%, partial in 29% and no improvement in 6% compared to CDSP group where 53% had a complete resolution, 41% partial resolution and 6% no improvement.

    Conclusions: No significant difference that shows any superiority in outcome of using CDSP over SSP in ACDF

    Patient Care: Determining ACDF technique with best outcome in fusion and less complications.

    Learning Objectives: Undertstanding the outcome of different ACDF techniques


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