Anterior Cervical Fusion With the Orion Locking Plate System

Study Design. This study was conducted to evaluate an anterior cervical fusion plate system, the Orion locking plate, regarding its surgical handling, hardware‐related failures, and short‐term and long‐term results. Objectives. A comprehensive evaluation of the implant in a broad range of patients with cervical spine diseases. Summary of Background Data. Locking plates are the most recent devices for achieving anterior cervical spinal fusion and offer considerable advantages such as faster and easier implantation and fewer implant‐related failures than older plate systems. Methods. Ninety‐six patients were investigated. All underwent anterior cervical plate fusion as a component of the surgical treatment for symptomatic degenerative cervical spinal disease or for vertebral destruction caused by trauma, tumor, or inflammation. Besides plate fixation, 6 of the 96 patients had a combined ventrodorsal fusion. In 28 cases, one or more vertebral bodies were removed and replaced with titanium placeholders. The remaining 62 patients were first treated by intervertebral inlay placement, and the fused segments were subsequently plated. Neurologic signs and symptoms were evaluated before and after surgery and during a follow‐up period of at least 1 year. Results. The rate of neurologic improvement was highest in radiculopathy patients and lowest in patients with severe myelopathy. In all cases, control radiographs demonstrated a solid bony fusion. Clinical deterioration after surgery was seen in four cases of severe myelopathy in which considerable neurologic deficits existed before surgery, possibly because of rapid decompression of the cord and associated microvascular alterations. In two of these cases, there was long‐term improvement. Additional general complications caused by surgical retraction included temporary swallowing disturbance in seven patients and a large wound hematoma in one. Hardware failures were encountered in three cases, all of them caused by improper implantation technique and not material failure, per se. Conclusion. In the study group, the Orion locking plate was easy to use, failure‐free if properly implanted, safe for the patient and supported solid bony fusion in every case.

[1]  C. Dickman,et al.  Radiographic and clinical follow-up review of Caspar plates in 49 patients. , 1996, Journal of neurosurgery.

[2]  V K Goel,et al.  Biomechanical evaluation of Caspar and Cervical Spine Locking Plate systems in a cadaveric model. , 1996, Journal of neurosurgery.

[3]  J. Taha,et al.  ORION anterior cervical plate system. Commentaries , 1996 .

[4]  T. Yoshimoto,et al.  Anterior cervical fixation with the titanium locking screw-plate: a preliminary report. , 1994, Surgical neurology.

[5]  V. Sonntag,et al.  Cervical corpectomy and plate fixation for postlaminectomy kyphosis. , 1994, Journal of neurosurgery.

[6]  D. Kunz,et al.  Anterior Cervical Discectomy, Fusion, and Plating: A Comparative Animal Study , 1993, Spine.

[7]  P. Connolly,et al.  Anterior Cervical Plate Fixation with the Titanium Hollow Screw Plate System , 1993, Spine.

[8]  H. L. Harkey.  Synthes Cervical Spine Locking Plate (Mosher Plate). , 1993 .

[9]  D. Rowed.  Management of cervical spinal cord injury in ankylosing spondylitis: the intervertebral disc as a cause of cord compression. , 1992, Journal of neurosurgery.

[10]  J. Kostuik,et al.  Anterior cervical plate fixation with the titanium hollow screw plate system. A preliminary report. , 1990 .

[11]  W Caspar,et al.  Anterior cervical fusion and Caspar plate stabilization for cervical trauma. , 1989, Neurosurgery.

[12]  V. Goel,et al.  Kinematics of the Cervical Spine Following Discectomy and Stabilization , 1989, Spine.

[13]  H. J. Senter,et al.  Anterior cervical discectomy with hydroxylapatite fusion. , 1989, Neurosurgery.

[14]  C. Probst,et al.  [Traumatic dislocations/dislocation fractures of the cervical spine. Neurosurgical experiences in 42 surgical patients]. , 1989, Aktuelle Traumatologie.

[15]  P. McAfee,et al.  One-stage anterior cervical decompression and posterior stabilization with circumferential arthrodesis. A study of twenty-four patients who had a traumatic or a neoplastic lesion. , 1989, The Journal of bone and joint surgery. American volume.

[16]  M. Cabanela,et al.  Anterior Plate Stabilization for Bursting Teardrop Fractures of the Cervical Spine , 1988, Spine.

[17]  Cloward Rb.  The anterior surgical approach to the cervical spine: the cloward procedure: past, present, and future ― The presidential guest lecture, cervical spine research society , 1988 .

[18]  Augustus A. White,et al.  Biomechanical Considerations in the Surgical Management of Cervical Spondylotic Myelopathy , 1988, Spine.

[19]  Jeffrey A. Brown,et al.  Cervical Stabilization by Plate and Bone Fusion , 1988, Spine.

[20]  T. Whitecloud,et al.  Cervical spondylotic myelopathy and myeloradiculopathy. Anterior decompression and stabilization with autogenous fibula strut graft. , 1987, Clinical orthopaedics and related research.

[21]  E. Morscher,et al.  [Anterior plating of the cervical spine with the hollow screw-plate system of titanium]. , 1986, Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen.

[22]  J. Böhler,et al.  Anterior plate stabilization for fracture-dislocations of the lower cervical spine. , 1980, The Journal of trauma.

[23]  L. Lavine,et al.  Cervical Spondylotic Radiculopathy: The Syndrome of Foraminal Constriction Treated by Foramenotomy and the Removal of Osteophytes , 1965, Clinical orthopaedics and related research.

[24]  R. B. Cloward.  Treatment of acute fractures and fracture-dislocations of the cervical spine by vertebral-body fusion. A report of eleven cases. , 1961, Journal of neurosurgery.