The value of anterior cervical plating in preventing vertebral fracture and graft extrusion after multilevel anterior cervical corpectomy with posterior wiring and fusion: indications, results, and complications.

Anterior cervical plates were added to anterior corpectomy and fusion (ACF) with posterior wiring and fusion (PWF) to prevent vertebral fracture and graft extrusion in patients with ossification of the posterior longitudinal ligament and spondylostenosis. From January 1989 to March 1997, 22 patients had an average 2.5-level ACF without plates and an average 5-level PWF with halo placement (average follow-up, 4 years). From April 1997 to October 1998, 22 patients had an average 2.8-level ACF with Orion plating and an average 5.4-level PWF with halo devices (patients were followed for an average of 11 months). Vertebral fracture and graft extrusion requiring revision developed in three (14%) patients without plates within 24 hours of surgery, whereas neither of these occurred in patients with plates (by Fisher's test: nonsignificant p value = 0.2326). Ultimately, all 44 patients had fusion. Thus far, vertebral fractures and graft extrusions have not been observed for 22 patients undergoing plated circumferential cervical surgery.