• Kamran Aghayev, James J Doulgeris, Sabrina A Gonzalez-Blohm, Mohammed Eleraky, William E Lee, and Frank D Vrionis.
• H. Lee Moffitt Cancer Center & Research Institute, NeuroOncology Program, Tampa, FL 33612, USA; Department of Neurosurgery and Orthopedics, College of Medicine, University of South Florida, Tampa, FL 33612, USA.
• Clin Biomech (Bristol, Avon). 2014 Jan 1; 29 (1): 21-5.

BackgroundCommon fusion techniques for cervical degenerative diseases include two-level anterior discectomy and fusion and one-level corpectomy and fusion. The aim of the study was to compare via in-vitro biomechanical testing the effects of a two-level anterior discectomy and fusion and a one-level corpectomy and fusion, with anterior plate reconstruction.MethodsSeven fresh frozen human cadaveric spines (C3-T1) were dissected from posterior musculature, preserving the integrity of ligaments and intervertebral discs. Initial biomechanical testing consisted of no-axial preload and 2Nm in flexion-extension, lateral bending and axial rotation. Thereafter, discectomies were performed at C4-5 and C5-6 levels, then two interbody cages and an anterior C4-C5-C6 plate was implanted. The flexibility tests were repeated and followed by C5 corpectomy and C4-C6 plate reconstruction. Biomechanical testing was performed again and statistical comparisons among the means of range of motion and axial rotation energy loss were investigated.FindingsThe two-level cage-plate construct had significantly lower range of motion than the one-level corpectomy-plate construct (P≤0.03). Axial rotation energy loss was significantly (P≤0.03) greater for the corpectomy-plate construct than for the two-level cage-plate construct and the intact condition.InterpretationA two-level cage-plate construct provides greater stability in flexion, extension and lateral bending motions when compared to a one-level corpectomy-plate construct. A two-level cage-plate is more likely to maintain axial balance by reducing the energy lost in axial rotation.© 2013.

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