A bone plating
system is provided that permits maintenance of a compression force while also accommodating bony
subsidence, among other features. Methods of implantation are also provided that improve alignment and placement during implantation and avoid maneuvers that weaken the vertebral bodies. A modular
distraction screw is placed during the initial stages of
surgery when all relevant landmarks are still intact. After completion of the surgical bone work, a proximal end of the
distraction screw is detached, leaving a protruding
distal segment implanted in the centerline of the vertebral bodies above and below the newly fused
disc space. A
bone plate is guided into proper position relative to the upper and lower
vertebra by attaching the
bone plate to the protruding distal segments. The distal segments of the
distraction screws are tightened onto the plate and the plate is held stationary while
bone screws are placed. The bone plating
system is also extendable, allowing additional
bone plates to be placed and coupled with existing plate components to create a multi-level plating
system. Additional
bone plates may be placed contemporaneously or during a subsequent surgical procedure.