Cervical Template to Optimize the Plate-To-Disc Distance in Instrumented Anterior Cervical Discectomies and Fusions: Instrumentation Assessment
BACKGROUND: An increased incidence of adjacent segment degeneration in the cervical spine has been associated with a plate-to-disc distance (PDD) of <5 mm. OBJECTIVE: To introduce a template to size, position, and secure a cervical plate and ensure a 5-mm minimum PDD. METHODS: A prospective observational study was performed on 50 consecutive patients who had single-level anterior cervical discectomy and fusion (ACDF) using a cervical template. The cervical template was secured into the interbody spacer and assessed for length, PDD, and adequate vertebral body coverage. Holes were drilled through the template, which was then removed for cervical plate placement. Postoperative radiographs were assessed for PDD to adjacent segments, the angle from the vertical axis of the spine, and distance from midline. Neck Disability Index and visual analog scale scores for the neck and arm were obtained preoperatively and at 30-d and 90-d follow-up. RESULTS: Fifty patients underwent single-level ACDFs. The mean angle from the long axis of the spine was 2.4 (0.0-4.4) degrees; mean distance from midline was 1.3 (0.0-2.8) mm; and mean distance from the plate ends to the adjacent segments above was 5.4 (4.6-6.2) mm, and below, 5.1 (4.3-5.8) mm. CONCLUSION: A cervical template can reliably secure the midline and predetermine the size of the shortest cervical plate for adequately stabilizing the segment for arthrodesis. Use of a template standardizes the process of maximizing the PDD.
Digital Object Identifier (DOI)
Tumialán, Luis M., "Cervical Template to Optimize the Plate-To-Disc Distance in Instrumented Anterior Cervical Discectomies and Fusions: Instrumentation Assessment" (2019). Neurosurgery. 80.