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The plating of the cervical spine

In operations on the cervical spine from the front (after removal of a herniated disc, relief of the spinal canal, vertebral body replacement, etc.), after the placing of an graft (substitute material for the removed disc), an additional stabilisation with a plate will be carried out. This is to prevent that the interposition (e.g. Cage, bone) slips (migrates) and the fusion, i.e. the installation of the bony interposition is done as quickly as possible since due to the plate, a compression (i.e. pressure) is exerted on the material. Everyone knows that if something is to stick together, then it must be pressed together well.

It also works similarly on the spine. There are different approaches, when using a so-called ventral plate (to press on each other). If only one disc is removed, often enough the primary anchor by the interposition suffices, so that it does not migrate (slips) and a fast fusion is achieved. Unless the instability is existent in the first place (e.g. spondylolisthesis), which can be seen on functional images. When two or more discs are removed, the ventral plating leads to higher fusion rates and faster fusion. There are several plates that can be used. Here the main difference is: rigid or dynamic. Dynamic disks, adapt to circumstances, i.e. when the graft slightly sinks (which is ultimately always the case), then the plate "slides" down and the interposition is still under pressure and can merge. For rigid plates, the graft is relieved by the "sinking", it is virtually hanging in the air. That a fusion ("bonding") is therefore made more difficult seems logical.

(Kopie 1)

[Translate to English:] Die starre Platte - Gefahr Schraubenbruch - Plattenlockerung
Bei einer starren Platte, d. h. die Platte kann ihre Position zu den Wirbelskörpern und dem Interponat nicht verändern, führt ein Sintern des Interponats zu einer Entlastung. Die Platte hängt quasi in der Luft und hat keinen Kontakt zu den Wirbelkörpern. Dadurch besteht ein Risiko für Schraubenlockerung, Schraubenbruch bzw. Dislokation der Platte.

In some clinical examples the surgery on the cervical spine from the front will be explained. The dynamic disk type "Mambo" by ulrich is used. The plate consists of individual parts, which can slide into one another, thus the dynamic is guaranteed. This is also well demonstrated in the video.
The implantation of the plate is unproblematic in the long run and not noticeable for the patient. Immediately after the operation, swallowing difficulties may occur, since the esophagus was kept aside during surgery. This leads to swelling, causing those swallowing difficulties. By sucking ice the ebbing-away-process can be accelerated.


The ventralplating with the mambo-plate