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Background: Anterior cervical plate had developed continuously, and this study aimed to assess the biomechanics of a novel self-locking plate system for anterior cervical fixation designed by ourselves. Methods: Twelve anterior cervical plates (i.e., six novel plates and six DePuy plates) were subjected to a pull-out test and a fatigue test. In addition, 12 C1-T1 cervical spine specimens underwent anterior cervical corpectomy and C5 fusion using six novel plates and six DePuy plates. Pre- and postoperative range of motion, load–displacement, axial stiffness, torque, and twisting stiffness were compared. Results: No differences in maximum pull-out force, relative displacement, or energy absorption were observed between the DePuy plates and the novel plates (P >0.05). The novel plate system could bear an average of 5.6 × 105 times of loading, while the DePuy plate could bear 5.4 × 105 times of loading. The fatigue strengths of the new plate system and the DePuy plate were 490.75 and 485.86 MPa, respectively. No differences in fatigue life or strength were observed between the two types of plates. Cervical spine stability increased significantly after internal fixation. No differences in range of motion, load–displacement, axial stiffness, torque, or twisting stiffness were observed between the novel self-locking plate and the DePuy plate (P >0.05). Conclusions: Compared to the DePuy plate, the novel anterior cervical self-locking plate system described here has good strength and fastening ability, allowing it to provide sufficient biomechanical stability. Further clinical assessment of this system is needed. [ABSTRACT FROM AUTHOR]

Background: There is considerable controversy as to which posterior technique is best for the treatment of multi-level cervical spondylotic myelopathy. The aim of this study was to compare the clinical and radiographic results and complications of laminoplasty (LAMP) and laminectomy (LAMT) in the treatment of multi-level cervical spondylotic myelopathy. Methods: We reviewed and analyzed papers published from January 1966 and June 2013 regarding the comparison of LAMP and LAMT for multi-level cervical spondylotic myelopathy. Statistical comparisons were made when appropriate. Results: Fifteen studies were included in this systematic review. There was no significant difference in the incidence of surgical complications between LAMP and LAMT. Compared to conventional LAMT and skip LAMT, postoperative ROM was more limited in LAMP, but this was still superior to postoperative ROM following LAMT with fusion. Postoperative kyphosis occurred in 8/180 (4.44%) in LAMP and 13/205 (6.34%) in LAMT, whereas no cases of kyphosis were reported for skip LAMT. Skip LAMT appears to have better clinical outcomes than LAMP, while the outcome was similar between LAMP and LAMT with fusion. Conclusions: Based on these results, a claim of superiority for laminoplasty or laminectomy was not justified. In deciding between the two procedures, the risks of surgical and neurological complications, and radiologic and clinical outcome, must be taken into consideration if both options are available in multi-level cervical spondylotic myelopathy. [ABSTRACT FROM AUTHOR]