Graft- and plate-related complications are not uncommon problems associated with anterior cervical fusion surgery. Although the reasons for such complications are protean, one potential set of etiologies centers on plate design. Dynamic cervical plates, which allow for better load sharing while providing overall resistance to motion, address perceived biomechanical deficiencies of rigid cervical plates. However, despite the theoretic advantages of dynamic plating over rigid plate fixation, there are concerns that settling associated with dynamic plates could lead to segmental kyphosis or foraminal narrowing and that excessive motion may lead to inferior fusion rates. The surgeon using these implants should be familiar with differences among the various types of dynamic plates and should perform the plating procedure appropriately to accommodate the expected settling.
