title: New technical tip for anterior cervical plating : make hole first and choose the proper plate size later.
abstract: OBJECTIVE
  It is well known that plate-to-disc distance (PDD) is closely related to adjacent-level ossification following anterior cervical plate placement. The study was undertaken to compare the outcomes of two different anterior cervical plating methods for degenerative cervical condition. Specifically, the new method involves making holes for plate screws first with an air drill and then choosing a plate size. The other method was standard, that is, decide on the plate size first, locate the plate on the anterior vertebral body, and then drilling the screw holes. Our null hypothesis was that the new technical tip may increase PDD as compared with the standard anterior cervical plating procedure.
  
  
  METHODS
  We retrospectively reviewed 49 patients who had a solid fusion after anterior cervical arthrodesis with a plate for the treatment of cervical disc degeneration. Twenty-three patients underwent the new anterior cervical plating technique (Group A) and 26 patients underwent the standard technique (Group B). PDD and ratios between PDD to anterior body heights (ABH) were measured using postoperative lateral radiographs. In addition, operating times and clinical results were reviewed in all cases.
  
  
  RESULTS
  The mean durations of follow-up were 16.42±5.99 (Group A) and 19.83±6.71 (Group B) months, range 12 to 35 months. Of these parameters mentioned above, cephalad PDD (5.43 versus 3.46 mm, p=0.005) and cephalad PDD/ABH (0.36 versus 0.23, p=0.004) were significantly greater in the Group A, whereas operation time for two segment arthrodesis (141.9 versus 170.6 minutes, p=0.047) was significantly lower in the Group A. There were no significant difference between the two groups in caudal PDD (5.92 versus 5.06 mm), caudal PDD/ABH (0.37 versus 0.32) and clinical results.
  
  
  CONCLUSIONS
  The new anterior cervical plating method represents an improvement over the standard method in terms of cephalad plate-to-disc distance and operating time.
authors: Department of Neurosurgery, Gangnam Severance Hospital, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Jeong Yoon
authors: JY
authors: Park
authors: Ho Yeol
authors: HY
authors: Zhang
authors: Min Chul
authors: MC
authors: Oh
references: Neurosurgery. 2002 Feb;50(2):229-36; discussion 236-8
references: 11844257
references: Spine J. 2007 Nov-Dec;7(6):637-42
references: 17998122
references: J Bone Joint Surg Am. 2005 Mar;87(3):558-63
references: 15741622
references: J Spinal Disord. 1995 Dec;8(6):500-8; discussion 499
references: 8605425
references: Spine (Phila Pa 1976). 1993 Oct 15;18(14):2043-7
references: 8272957
references: Neurosurg Clin N Am. 2005 Oct;16(4):575-87, v
references: 16326280
references: J Spinal Disord. 2001 Feb;14(1):3-9
references: 11242268
references: Arch Orthop Trauma Surg. 1985;104(4):247-50
references: 4084040
references: Unfallchirurgie. 1988 Oct;14(5):247-58
references: 3238817
references: J Spinal Disord. 1999 Jun;12(3):215-20; discussion 221
references: 10382774
references: Neurosurgery. 1994 Jul;35(1):64-8
references: 7936154
references: J Bone Joint Surg Am. 1958 Jun;40-A(3):607-24
references: 13539086
references: Spine (Phila Pa 1976). 2009 Jan 1;34(1):30-3
references: 19127159
references: J Neurosurg. 2002 Sep;97(2 Suppl):186-92
references: 12296677
references: Spine (Phila Pa 1976). 1980 Sep-Oct;5(5):399-401
references: 7455770
references: J Spinal Disord. 2001 Feb;14(1):10-6
references: 11242269
references: Spine J. 2010 Mar;10(3):193-9
references: 19850532
references: Skeletal Radiol. 1986;15(7):556-9
references: 3775422
references: Clin Orthop Relat Res. 1991 Feb;(263):13-29
references: 1899635
references: Spine (Phila Pa 1976). 2001 Mar 15;26(6):643-6; discussion 646-7
references: 11246376
references: Spine (Phila Pa 1976). 1993 Nov;18(15):2167-73
references: 8278827