The Effect of Dynamic Versus Static Plating Systems on Fusion Rates and Complications in 1-Level and/or 2-Level Anterior Cervical Discectomy and Fusion A Systematic Review

Study Design: A systematic review. Objective: To determine the effect of plate design on fusion rates in patients undergoing a 1-and 2-level anterior cervical discectomy and fusion (ACDF). Methods: Articles published between January 1, 2002 and January 1, 2015 were systematically reviewed to determine the fusion rate of 1-and 2-level ACDFs using either a fully constrained or semiconstrained locking plate. Additional variables that were collected included the number of levels, the type of graft/cage used, the study design, the method for determining fusion, and complications. Results: Fifty-two articles and 3053 patients were included. No significant difference in the fusion rate for 1- and 2-level ACDF using a fully constrained plate (96.1%) and a semiconstrained plate (95.29%) was identified (P = 0.84). No difference (P = 0.85) in the total complication rate between fully constrained plates (3.20%) and semiconstrained plates (3.66%), or the rate of complications that required a revision (2.17% vs. 2.41%, P = 0.82) was identified. However, semiconstrained plates had a nonsignificant increase in total dysphagia rates (odds ratio = 1.660, P = 0.28) and short-term dysphagia rates (odds ratio = 2.349, P = 0.10). Conclusions: In patients undergoing a 1- or 2-level ACDF, there is no significant difference in the fusion or complication rate between fully constrained plates and semiconstrained plates.