Fig. 3.

Computer model depicts a conceivable design of an ATPS–plate system with asymmetrical plate holes proximally and distally, respecting asymmetric entry points for ATPS at C3–T1. Here, a conceivable design of a four-level instrumentation, e.g., C4–T1, is depicted. At the end-levels, proximal oval hole perforations are located, e.g., more left sided for an ATPS directing rightwards, and circular and slightly oval holes proximal and distal, respectively, directing leftwards for triangulated anterior vertebral body screws. Midsection of the plate marks space for a conceivable translation mechanism. With the plate enabled to translate the proximal towards the distal plate holes according to given entry points of the ATPS will support its clinical feasibility. The insertion of 3.5–4.5 mm ATPS will follow the insertion of a k-wire placed albeit parallel to the endplates to be instrumented. Afterwards, an ATPS-plate is chosen adjusted to the length of levels to be instrumented and translation is performed. Due to the oval holes, the differing entry points of the k-wires cranially and caudally in transverse plane can be compensated due to translation of the plate more medially or laterally along the longitudinal axis