ArticleJournal of spine surgery (Hong Kong)2025
Long cervical fusions: are multiple segmental plates less likely to fail than a single long plate?
Article in Journal of spine surgery (Hong Kong), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Considering biomechanical environment in the prevention and treatment of ACDF complications.Journal of spine surgery (Hong Kong) · 2026Article
- Article
- Comparative analysis of the biomechanics of anterior cervical discectomy and fusion with multiple segmental plates fixation versus single multilevel plate fixation: a finite element study.BMC musculoskeletal disorders · 2022Article
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Anterior cervical discectomy and fusion (ACDF) is widely performed for cervical pathology, yet multilevel anterior constructs are associated with higher rates of dysphagia, pseudoarthrosis, and mechanical failure-particularly at the caudal segment. These complications may arise from stress concentration and load transfer through long anterior cervical plates. Segmentally separated fixation, utilizing multiple short plates rather than a single long plate, may reduce these risks by limiting exposure, shortening operative time, and distributing mechanical loads more evenly. The purpose of this study was to compare the biomechanical behavior of multilevel ACDF constructs stabilized with multiple segmental plates versus a single long plate. Methods: Twelve fresh-frozen human cadaveric cervical spines (C4-C7) underwent ACDF using either a single long plate or multiple segmental plates. Bone quality was quantified via C7 trabecular Hounsfield units on computed tomography (CT), and specimens were randomized by density. Identical constructs were also tested in polyurethane foam cervical models to minimize biological variability. Specimens were mounted to multiaxial test platforms and subjected to fatigue cycling under flexion-extension, lateral bending, and axial rotation. Construct stiffness was recorded at baseline and after 1,500 cycles in each motion plane. Stiffness loss was analyzed with one-way analysis of variance (ANOVA) and normalized to bone density. Results: Initial construct stiffness did not differ between groups (P=0.86). After cyclic loading, multiple segmental plates demonstrated significantly greater stiffness retention in axial rotation (51%±10% Conclusions: Segmentally separated anterior fixation for multilevel ACDF preserves rotational stiffness at the caudal segment more effectively than long single-plate constructs in controlled models. This suggests a potential mechanical advantage that may translate to reduced stress concentration and lower failure risk in multilevel anterior cervical reconstructions. Further
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