Question:The doctor is advising me to have a cervical spine fusion with bone graft and titanium plates. Do I really need both?
Many studies have been done in this area of research. Scientists want to know if bone graft alone is enough? Does adding plates and screws called instrumentation make a difference? How much of a difference -- enough to make it worth using both methods of fixation?
Some researchers are looking at the fusion rate of a single-level spinal fusion with and without instrumentation. They are comparing the risk-to-benefit of adding a cervical plate. So far it looks like there is a fairly high fusion rate (90 percent) with a single-level fusion using only bone graft.
Adding an anterior cervical plate (ACP) bumps this up to 96 percent. They also noted there are fewer pseudoarthrosis rates in patients with plate fixation. Pseudoarthrosis means the fused area is moving enough to act like a joint. This is considered a fusion failure.
They are also looking at the results of fusion at several levels. Success without instrumentation is much lower in this group. All in all it looks like bone graft with instrumentation is a good idea, especially if you are having more than one level fused.Christopher P. Ames, MD, et al. Biomechanical Analysis of a Newly Designed Bioabsorbable Anterior Cervical Plate. In Journal of Neurosurgery:Spine. December 2005. Vol. 3. No. 6. Pp. 465-470.
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