Abstract
Introduction Anterior correction of cervical kyphotic deformity in traumatic and degenerative spine is a well established technique. The application of an anterior cervical plate is widely accepted, particularly in multilevel discectomies. However the placement of the cervical plate flush against the cortical margins of the spine remains challenging particularly when there is an underlying subluxation. Contouring the cervical plate with a plate bender is suggested. Others have described the use of an adjustable depth tap (1).
We describe the technique of utilizing the Trimline™ Vertebral Body Distractor in correction of the sagittal plane deformity and maximizing the contact surface between plate and fusion construct
Methods The technique is described in a case each of cervical trauma and degenerative cervical spondylolisthesis. The Trimline™ distractor which utilizes cannulated legs, threaded pins and nuts is used as a direct reduction tool correcting the cervical lordosis, before discectomy. The distractor pins are placed bilaterally in the vertebral bodies at the level of the deformity, and at the level above and below. The distractors are applied bilaterally and reduction undertaken. The distraction device is locked in place whilst the discectomy is performed. Distraction device is removed once graft is in-situ and cervical plate is applied in routine manner.
Results Bilateral application of pins and distraction device provides better reduction strength, and better distributes distraction forces minimizing further fracture. This optimizes correction of cervical kyphotic deformity and prevents obstruction of operative view for discectomy and fusion.
Discussion Restoration of the normal cervical lordotic curve in traumatic and degenerative spinal disease remains challenging. Flush application of the anterior cervical plate to the anterior border of the spine and graft enhances spinal fusion, stability and alignment. The use of bilateral vertebral body distractor devices to reduce cervical subluxation and enhance implant-bone interface is a novel technique which is safe and not time consuming.
The abstracts were prepared by Assoc Prof Bruce McPhee. Correspondence should be addressed to him at the Division of Orthopaedics, The University of Queensland, Clinical Sciences Building, Royal Brisbane Hospital, Herston, Brisbane, 4029, Australia.
Reference
1 Jea A, Vanni S. J Spinal Disord Tech2004; 18: 178–181. Google Scholar
