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Orthop Surg. 2017 Aug;9(3):290-295. doi: 10.1111/os.12339.

Biomechanical Stability Analysis of a Stand-alone Cage, Static and Rotational-dynamic Plate in a Two-level Cervical Fusion Construct.

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Musculoskeletal Biomechanics Laboratory, Edward Hines Jr. VA Hospital, Hines, Illinois, USA.
Department of Orthopaedic Surgery and Rehabilitation, Loyola University Chicago, Maywood, Illinois, USA.



To test the following hypotheses: (i) anterior cervical discetomy and fusion (ACDF) using stand-alone interbody spacers will significantly reduce the range of motion from intact spine; and (ii) the use of a static or a rotational-dynamic plate will significantly augment the stability of stand-alone interbody spacers, with similar beneficial effect when compared to each other.


Eleven human cadaveric subaxial cervical spines (age: 48.2 ± 5.4 years) were tested under the following sequence: (i) intact spine; (ii) ACDF at C4 -C5 using a stand-alone interbody spacer; (iii) ACDF at C5 -C6 and insertion of an interbody spacer (two-level construct); and (iv) randomized placement of either a two-level locking static plate or a rotational-dynamic plate.


Insertion of stand-alone cage at C4 -C5 and C5 -C6 caused a significant decrease in the range of motion compared to intact spine (P < 0.05). Placement of both the locking and the rotational dynamic plate further reduced the range of motion at C4 -C5 and C5 -C6 compared to stand-alone cage (P < 0.01). No significant differences in range of motion restriction at either C4 -C5 or C5 -C6 were found when the two plating systems were compared (P > 0.05).


Cervical stand-alone interbody spacers caused significant restriction in the range of motion. Both plates significantly augmented the stability of stand-alone interbody spacers, with similar stabilizing effect.


Anterior cervical discectomy and fusion; Biomechanics; Plating; Range of motion; Stand-alone cages

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