*5.2.4 Implant*

Depending on the surgical indications related to the pathology, the level affected and the presence of deformity, different implants are used in anterior cervical surgeries. According to his/her experience and preferences, the surgeon may use stand-alone cage, hybrid cage, cervical plating, or total disc replacement [34].

The use of cervical plate in ACDF remain a controversy issue, especially in single and two levels degenerative disc disease, but many studies support its use in more than 2 levels in degenerative spine, in trauma, tumor, infections, especially if corpectomies are advocated.

Plating has the advantage of increase fusion rate, better lordotic reconstruction, enhanced primary stability of the construct, superior disc height preservation and lower subsidence rate [35]. However these benefits come at the cost of screw

#### *Dysphagia Following Anterior Cervical Spine Surgery DOI: http://dx.doi.org/10.5772/intechopen.101799*

pullout, loosening of plate, hardware breakage, increase in the operative time and overall costs, and increased risk of dysphagia [34].

Total disc arthroplasty (TDR) become popularized in last decades as a motion preserving technique in the anterior cervical surgeries, avoiding the fusion and decrease the adverse effect of ACDF, in selected indications. However, studies found no difference in the risk of dysphagia when comparing between TDR and ACDF [36].
