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Objective:Anterior cervical fusion is widely used with many kinds of plate systems. The purpose of this study is to evaluate the rate and influencing factor of instrument failure. Methods:The authors reviewed 101 consecutive patients who underwent anterior interbody fusion used Caspar, PCB(Cervical Plate Cage System), Orion and Atlantis plate system during the period of January 1991 to December 2000. The cases of trauma were 49, tumor 2 and degenerative disorder 50. The average length of follow up was 12.2 months. Results:There were 10 cases of instrument related complications and 18 cases of non-instrument related complications. Among 10 cases of instrument related complication, eight patients showed screw loosening and two patients showed bone graft displacement. The nine cases of hardware failure occurred within 3 months. The rate of instrument failure was higher in trauma, unlocking plate and multi-level than non-trauma, locking plate and one-level. There were no injuries to tracheoesophageal or neurovascular structures as a results of instrument failure. Conclusion:We conclude that anterior cervical plating can be carried out with acceptable complication rate. The incidence of prominent instrument failure that endangers tracheoesophageal structures is minimal. Key words:Anterior cervical fusion;Cervical plate;Instrument failure.