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A very specific question about ACDF hardware

hi all,

greetings! this is my first post here and i’d be extremely
grateful to anyone who can shed light on some specific technical aspects of a
3-level acdf i have scheduled in 3 weeks time.

i’ve had chronic pain for 11 years caused by bulging disc, spinal
stenosis and bone spurs c4-c7. the stenosis is most pronounced at c5-c6 and c6-c7,
while the c4-c5 level has smaller bone spurs.

the surgeon’s office mentions in an email some details about
the hardware to be used:

“he will
be using a titanium cage at the c4-5 level called the biomet solitaire-c and at
the c5-6 and c6-7 levels, he will be using the plates and screws that i showed
you which is called the biomet maxan plate.”

(photos added here for reference)

 related image

biomet solitaire-c cage

image result for the biomet maxan plate

maxan plate

to this i asked why he
would use a cage at the 4-5 level, as opposed to covering all 3 levels with a plate
(which is what i usually see in photos) and they replied:

“in your particular case, because you are having a surgery
across 3 levels, rather than using a plate spanning across 3 levels, dr. r
would prefer to use a shorter plate to span only across two levels to minimize
the surgery time under general anesthesia. using a shorter plate would mean a
faster operation and he was also thinking long term - if you ever need to have
surgery at the next lower level below c7, its easier to remove a short plate so
overall its better for the patient. this is why he opted to use a cage
at the c4-5 level instead.”

i’m wondering if anyone
here can vouch for this explanation?  this
is my first cervical operation, and i’d like to understand more about the various
hardware options for the acdf fusion procedure (i’m not a candidate for
artificial disc replacement due to stenosis and bone spurs being too advanced).

my surgery is just a few
weeks away and after getting many second opinions i’m still very happy with my choice in surgeon
and confident that i’m on the right track heading into this - i’m just trying
to learn more technical details about the process that lies ahead.

thanks again in advance!




  • fr33

    Welcome to Spine-Health

    There seems to be a lot of differences in technique and after care between doctor's, I had the same level as your's fused in Feb. 2018, my surgeon used a plate for all levels, after surgery I was only required to wear a soft collar when I was in a vehicle, I have seen where there are some patients that have to wear a hard collar for 6 weeks.

    I think it comes down to the doctor's training and personal preference.


    Veritas-Health Moderator

  • Fr33, Chip is 100% correct in saying that it’s typically the surgeons choice and what he feels is the best treatment for you. Listening to his explanation makes sense! When you start talking adjacent disk disease, unsuccessful fusion, this cage definitely makes sense to me. ( my fusion failed ) Most surgeons won’t do 2 ACDF,s instead the second one they go posterior which has many more issues, so I can understand his rationale in using this cage......David


    Veritas-Health Forum Moderator

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  • Thanks guys. I guess I'm just nervous going into this thing. David sorry to hear about your failed fusion, friend.

  • Fr33, We all can understand the nervous feeling! I would be worried if you weren’t! Have faith in your surgeon and his team! Please keep us posted on how things are going......David


    Veritas-Health Forum Moderator

  • We'll do

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  • fr33, thank you for posting this as I have been searching for more information and member experiences with the various hardware used. My doctor will be using Biomet also, but now I will be finding out more specifics on the hardware  (cage, etc.) - thanks to your post.

  • As my surgery is also in a few weeks, I have sent an inquiry on the hardware being used and will share the information .

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