ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Endplate preparation for anterior cervical discectomy and fusion: does the amount of endplate removed affect cage subsidence risk?
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The trial behind it
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Who cites it
2 citing papers in PubMed.
- Risk of subsidence following ACDF with the coalition™ (Globus Medical) cage: a multivariable analysis identifying preoperative radiculopathy as the primary risk factor.Acta neurochirurgica · 2026Article
- Deciphering subsidence risk after ACDF: a biomechanical study on bone density and endplate thickness.BMC musculoskeletal disorders · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purposeSubsidence after anterior cervical discectomy and fusion (ACDF) is a common complication that may be influenced by the degree of endplate removal prior to cage insertion. The optimal degree of endplate removal remains unclear; therefore, we performed a series of ex vivo experiments to elucidate the relationship between the aggressiveness of endplate preparation and subsidence risk.
methodsHuman cadaveric subaxial cervical endplates were partially decorticated either conservatively (n = 10) or aggressively (n = 9). The degree of endplate removal was quantified using microCT. Subsidence was modelled by measuring the strength and stiffness of each specimen when an interbody cage was axially compressed into the endplate.
resultsConservative endplate preparation resulted in less endplate removal than aggressive endplate preparation (mass: 150 vs. 301 mg, p < 0.001; volume: 47 vs. 88mm
conclusionsWhen performing partial cervical endplate decortication, the degree of bony endplate removal did not significantly predict endplate integrity during ex vivo compression testing, but greater BMD was associated with increased strength. The degree of endplate removal should be based on individual patient factors and intraoperative findings to achieve the ideal cage-endplate interface.
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Registered trials
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