ArticleNeurospine2024
Biomechanical Analysis of Hybrid Artificial Discs or Zero-Profile Devices for Treating 1-Level Adjacent Segment Degeneration in ACDF Revision Surgery.
Article in Neurospine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Effect of Keeping Caspar Retractor During Prestige LP Cervical Disc Implantation on Intra- and Postoperative Outcomes.Orthopaedic surgery · 2026Article
- Zero-profile interbody fusion in single and two-level anterior cervical discectomy and fusion: a novel surgical system and its indications.Journal of spine surgery (Hong Kong) · 2026Article
- Is zero-profile fixation safe in consecutive two-level anterior cervical discectomy and fusion with partial uncinate resection? A finite element analysis.BMC musculoskeletal disorders · 2025Article
- Biomechanical Changes in Kyphotic Cervical Spine After Anterior Cervical Discectomy and Fusion with Different Degrees of Correction.Bioengineering (Basel, Switzerland) · 2025Article
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Authors and funding
6 authors.
Funding
Abstract
objectiveCervical hybrid surgery optimizes the use of cervical disc arthroplasty (CDA) and zero-profile (ZOP) devices in anterior cervical discectomy and fusion (ACDF) but lacks uniform combination and biomechanical standards, especially in revision surgery (RS). This study aimed to investigate the biomechanical characteristics of adjacent segments of the different hybrid RS constructs in ACDF RS.
methodsAn intact 3-dimensional finite element model generated a normal cervical spine (C2-T1). This model was modified to the primary C5-6 ACDF model. Three RS models were created to treat C4-5 adjacent segment degeneration through implanting cages plus plates (Cage-Cage), ZOP devices (ZOP-Cage), or Bryan discs (CDA-Cage). A 1.0-Nm moment was applied to the primary C5-6 ACDF model to generate total C2-T1 range of motions (ROMs). Subsequently, a displacement load was applied to all RS models to match the total C2-T1 ROMs of the primary ACDF model.
resultsThe ZOP-Cage model showed lower biomechanical responses including ROM, intradiscal pressure, maximum von Mises stress in discs, and facet joint force in adjacent segments compared to the Cage-Cage model. The CDA-Cage model exhibited the lowest biomechanical responses and ROM ratio at adjacent segments among all RS models, closely approached or lower than those in the primary ACDF model in most motion directions. Additionally, the maximum von Mises stress on the C3-4 and C6-7 discs increased in the Cage-Cage and ZOP-Cage models but decreased in the CDA-Cage model when compared to the primary ACDF model.
conclusionThe CDA-Cage construct had the lowest biomechanical responses with minimal kinematic change of adjacent segments. ZOP-Cage is the next best choice, especially if CDA is not suitable. This study provides a biomechanical reference for clinical hybrid RS decision-making to reduce the risk of ASD recurrence.
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