Anterior correction of cervical spine lordosis using an adjustable depth tap: technical note.
OBJECTIVE
In cases of multilevel anterior cervical spine decompression where intervening vertebral bodies need to be incorporated into the anterior plate construct, it may be difficult to apply the plate flush against the entire anterior cortical surface of the spine segment. Some have suggested using the levering property of bicortical screws to "pull" the body against the plate. Others have recommended contouring the anterior cervical plate with a plate bender. The objective of this work was to describe a novel technique using the adjustable depth tap provided in the Atlantis plating system for achieving cervical spine alignment against the lordotic plate after multilevel anterior decompression.


METHODS
We describe an illustrative case of a 14-year-old girl with complex cervical spine fractures after trauma. We used the 4.0-mm adjustable depth tap in the Atlantis plating system to lever the C4 body against the premachined lordotic plate.


RESULTS
Cervical lordosis and anterior cervical plate placement were accomplished after multilevel anterior cervical decompression with the use of an adjustable depth tap.


CONCLUSIONS
Bicortical screw placement and plate bending have drawbacks in trying to apply the anterior cervical plate firmly to the anterior surface of the cervical spine. We describe a new and safe technique of using an adjustable depth tap for achieving that same goal without any obvious drawbacks.
Jea
Andrew
A
Department of Neurological Surgery, University of Miami School of Medicine, Miami, FL 33136, USA.
Vanni
Steven
S
D000293:Adolescent; D000886:Anthropometry / Q000295:instrumentation / Q000379:methods; D001860:Bone Plates / Q000592:standards; D001863:Bone Screws / Q000592:standards; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000592:standards*; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome