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Eleanor7734 · 02-19-2010, 05:48 PM

Hello,
I came across this board while I am recovering from 5 level ACDF surgery. Does anyone have knowledge of fixed plates vs. dynamic plates fusion rates? From what I have read, the opinions are all across the board and there are a few studies out there.

Thanks!

PNo · 02-19-2010, 06:08 PM

Hello and welcome! I hope you have a good recovery. From what I have been told by my neurosurgeon they are relunctant in most patients to use the dynamic plates because of the propensity towards settling, graft destruction, and concerns with the plate overlapping and injuring adjacent disc spaces from the settling, and also some increased kyphosis, foraminal stenosis, and construct failure. We considered it and decided against. He told me there are some surgeons using variable angle screws in a nonslotted plates - to try to offset threse problems, but still not enough literature to know the correct answer. THey need to follow some of these patients long term and do the comparison.

Which type fixation did they use on you?

Ilovemycutedog · 02-19-2010, 06:25 PM

Wow! I have never heard/talked to someone who has had a 5 level cervical fusion...let alone going through the front only and not posterior as well! It is rare to see a 3 level cervical and that is usually done in extreme cases with some type of accident..

May I ask what happened to you to cause them to do this? What levels?

How are you doing? That has to be an extremely traumatic surgery to the neck with loss of range of motion...so sorry you had to have that done...

I agree with neckpatient as my surgeons' felt the same about the plates...Did you also receive BMP with the fusion? This was added to my 3rd surgery which seems to have helped it fuse better this time around..(2 level 360 fusion for me)..

If you feel like sharing more..I would certainly like to hear how this all came about for you...

Take care..

Eleanor7734 · 02-19-2010, 08:48 PM

They used a fixed plate since the stability was an issue. I was in a car accident when I was about 17 and over the years, it hasnt really bothered me. I think I lost about 18% turning function from the accident. I began to develop bone spurs and osteoarithitis as well as finding out I have a Chiari type 1 malformation. Two years ago I started having cervical migraines and neuropathy, loss of sensation in fingers. It has taken me that long to find someone to listen to me! Sorry it wasnt five joints but five plates, so it was c3-c7. The scar is about 4 inches long from the front, as well as the bone graft they took from my hip. Yeah it hurts like heck, but I am more concerned about graft failure since it is so many of them at one time! I am sorry I do not know what BMP stands for. I am doing CervicalStim at home 4 hours a day and managing with pain killers. They sent me home in 23 hours so... Thanks for the well wishes!

Ilovemycutedog · 02-20-2010, 04:01 AM

Thanks for sharing more details...I was wondering about 5 levels as that would be more than I had ever seen!!

My first surgery they used the bone from my hip...that can be quite sore too!...

But you definitely had a huge surgery and yes..I'm sure it is still very painful...takes such a long time to heal and fuse..

Unfortunately...that is one of the risks/chances we have with any surgery is non-fusion..you have a slightly higher rate of fusion with using your own bone so that is good..
People who smoke take the percentage down to 12% success rate...

My third surgery they went in from the front and the back of my neck...took out all the old plating/screws and added a lot more plating to stabilize..

BMP is Bone Morphogenetic Protein...used when donor bone is used (this las surgery)...

But you cleared up that they used your own bone..

Isn't it crazy how fast they get us out of the hospital these days?? I remember my teengae years when an appendectomy was a week stay...I had my appendix out the day before Thanksgiving years ago..in at 11am...out by 3pm!!

I truly hope that you heal fully and fuse and that your pain gets less and less each day! The stim should help too...and hopefully they have you set up for PT later on...

Take care

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