title: Loss of lordosis and clinical outcomes after anterior cervical fusion with dynamic rotational plates.
abstract: OBJECTIVE
  The cervical dynamic rotational plating system may induce bone graft subsidence, so it may cause loss of cervical lordosis. However there were few studies for alignments of cervical spines influencing the clinical results after using dynamic rotational plates. The purpose is to evaluate the effect of graft subsidence on cervical alignments due to the dynamic rotational cervical plates and correlating it with the clinical outcomes of patients undergoing anterior cervical fusion.
  
  
  METHODS
  Thirty-three patients with disease or fracture underwent anterior cervical decompression and fusion using a dynamic rotational plate. The presence and extent of implant complications, graft subsidence, loss of lordosis were identified and Visual Analog Scale score (VAS score), Japanese Orthopaedic Association score (JOA score), clinical outcomes based on Odom's criteria were recorded.
  
  
  RESULTS
  Fusion was achieved without implant complications in all cases. The mean graft subsidence at 6 months after the surgery was 1.46 mm. The lordotic changes in local cervical angles were 5.85° which was obtained postoperatively. VAS score for radicular pain was improved by 5.19 and the JOA score was improved by 3. Clinical outcomes based on Odom's criteria showed sixteen excellent, ten good and two satisfactory results. There was no significant relationship between clinical outcomes and changes in the cervical angles.
  
  
  CONCLUSIONS
  Dynamic rotational anterior cervical plating provides comparable clinical outcomes to that of the reports of former static cervical platings. The loss of lordosis is related to the amount of graft settling but it is not related to the clinical outcomes.
authors.affiliation: Department of Orthopaedic Surgery, Kangdong Sacred Heart Hospital, Medical College of Hallym University, Seoul, Korea.
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Moon Soo
authors.initials: MS
authors.lastname: Park
authors.forename: Seong-Hwan
authors.initials: SH
authors.lastname: Moon
authors.forename: Jae-Hyuk
authors.initials: JH
authors.lastname: Shin
authors.forename: Seok Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Yong-Chan
authors.initials: YC
authors.lastname: Kim
authors.forename: Seong Jin
authors.initials: SJ
authors.lastname: Lee
authors.forename: Bo-Kyung
authors.initials: BK
authors.lastname: Suh
authors.forename: Hwan-Mo
authors.initials: HM
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation; D016896:Treatment Outcome
keywords: Cervical alignment; cervical fusion; dynamic rotational cervical plates; subsidence
references.citation: J Trauma. 1980 Mar;20(3):203-5
references.pmid: 7359594
references.citation: Eur Spine J. 2007 Sep;16(9):1395-400
references.pmid: 17221174
references.citation: Spine (Phila Pa 1976). 2001 Jan 15;26(2):161-5
references.pmid: 11154536
references.citation: Eur Spine J. 2001 Aug;10(4):320-4
references.pmid: 11563618
references.citation: Spine J. 2007 Mar-Apr;7(2):188-93
references.pmid: 17321968
references.citation: Spine (Phila Pa 1976). 2009 Jul 1;34(15):1567-71
references.pmid: 19564766
references.citation: J Neurosurg. 2004 Jan;100(1 Suppl Spine):13-9
references.pmid: 14748568
references.citation: J Neurosurg. 2003 Jan;98(1 Suppl):8-13
references.pmid: 12546382
references.citation: J Bone Joint Surg Am. 1958 Jun;40-A(3):607-24
references.pmid: 13539086
references.citation: Spine (Phila Pa 1976). 2001 Jun 15;26(12):1324-9
references.pmid: 11426146
references.citation: Spine J. 2010 May;10(5):417-21
references.pmid: 20338828
references.citation: Spine (Phila Pa 1976). 2007 Jun 1;32(13):E371-5
references.pmid: 17545900
references.citation: Spine (Phila Pa 1976). 2009 Apr 1;34(7):641-6
references.pmid: 19287352
references.citation: Spine J. 2009 Feb;9(2):121-7
references.pmid: 18261963
references.citation: Spine (Phila Pa 1976). 2011 Apr 20;36(9):E582-7
references.pmid: 20508548
references.citation: J Bone Joint Surg Am. 2006 Jul;88(7):1566-73
references.pmid: 16818983
references.citation: Eur Spine J. 2007 Oct;16(10):1689-94
references.pmid: 17684777