Intraoperative and Postoperative Complications of Internal Fixation with AO-plates

Indications for fusion of an intervertebral segment of the cervical spine include managing trauma, tumor, and instability which has been produced by an operative procedure (e.g. spondylectomy). Implanting bone will not produce adequate immediate stability. The cervical spine must still be immobilized after such an operation. Particularly with marked instability as in trauma or spondylectomy, it is often necessary to immobilize the cervical spine with external fixation (halo). This is considerably annoying for the patient. For this reason, procedures have been developed to create sufficient stability intraoperatively so that postoperative immobilization is not needed. Originally used in orthopedic surgery of the extremities, metal implants have been adopted for fixation of the spine. By using metal plates, postoperative immobilization can be avoided. However, this technique has associated with it the following disadvantages. By drilling the holes required for the screws, the esophagus, vessels, dura or even the spinal cord may be damaged; the plates may loosen and cause injury to the esophagus; and implantation of foreign bodies increases the risk of infection.