{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T11:07:48Z","timestamp":1787742468832,"version":"build-2784847793"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81802218"],"award-info":[{"award-number":["81802218"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Multilevel cervical spondylotic myelopathy poses significant challenges in selecting optimal surgical approaches, warranting a comprehensive understanding of their biomechanical impacts. Given the lack of consensus regarding the most effective technique, this study aims to fill this critical knowledge gap by rigorously assessing and comparing the biomechanical properties of three distinct surgical interventions, including anterior controllable antedisplacement and fusion (ACAF), anterior cervical corpectomy decompression and fusion (ACCF), and anterior cervical discectomy and fusion (ACDF). The study offers pivotal insights to enhance treatment precision and patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The construction of the cervical spine model involved a detailed process using CT data, specialized software (Mimics, Geomagic Studio, and Hypermesh) and material properties obtained from prior studies. Surgical instruments were modeled (titanium mesh, anterior cervical plate, interbody cage, and self\u2010tapping screws) to simulate three surgical approaches: ACAF, ACCF, and ACDF, each with specific procedures replicating clinical protocols. A 75\u2010N follower load with 2\u2009Nm was applied to simulate biomechanical effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The range of motion decreased more after surgery for ACAF and ACDF than for ACCF, especially in flexion and lateral bending. ACCF have higher stress peaks in the fixation system than those of ACAF and ACDF, especially in flexion. The maximum von Mises stresses of the bone\u2013screw interfaces at C3 of ACCF were higher than those of ACAF and ACDF. The maximum von Mises stresses of the bone\u2013screw interfaces at C6 of ACDF were much higher than those of ACAF and ACCF. The maximum von Mises stresses of the grafts of ACCF and ACAF were much higher than those of ACDF. The maximum von Mises stresses of the endplate of ACCF were much higher than those of ACAF and ACDF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The ACAF and ACDF models demonstrated superior cervical reconstruction stability over the ACCF model. ACAF exhibited lower risks of internal fixation failure and cage subsidence compared to ACCF, making it a promising approach. However, while ACAF revealed improved stability over ACCF, higher rates of subsidence and internal fixation failure persisted compared to ACDF, suggesting the need for further exploration of ACAF's long\u2010term efficacy and potential improvements in clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.13994","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T04:05:31Z","timestamp":1707278731000},"page":"687-699","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Biomechanical Comparison of Anterior Cervical Corpectomy Decompression and Fusion, Anterior Cervical Discectomy and Fusion, and Anterior Controllable Antedisplacement and Fusion in the Surgical Treatment of Multilevel Cervical Spondylotic Myelopathy: A Finite Element Analysis"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3788-305X","authenticated-orcid":false,"given":"Qingjie","family":"Kong","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Shanghai General Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3407-0715","authenticated-orcid":false,"given":"Fudong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Shanghai Changzheng Hospital Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Shanghai Changzheng Hospital Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingchuan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Shanghai Changzheng Hospital Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peidong","family":"Sun","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Medical Biomechanics, Department of Anatomy Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ou\u2010Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Shanghai Changzheng Hospital Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shizhen","family":"Zhong","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Medical Biomechanics, Department of Anatomy Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Shanghai Changzheng Hospital Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2133-0108","authenticated-orcid":false,"given":"Jiangang","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Shanghai Changzheng Hospital Second Military Medical University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2016.4891"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3182a7eaaf"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2020.02.190195"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-015-3911-4"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.919270"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.12.SPINE14545"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-019-3036-8"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.2.SPINE11611"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000257566.91177.cb"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-016-4555-8"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200106010-00016"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-017-5437-4"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.12.212"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000003462"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12856"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000024900"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5813-8"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-019-03182-y"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-2992-1"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-019-2425-3"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181f5cb87"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.02.004"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.4036393"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000008597"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000012046"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200112150-00012"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2018.09.008"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2015.09.025"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318068b30a"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2006.05.005"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200404150-00005"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.3171\/2021.8.SPINE21879"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2005.3.3.0205"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.14444\/3030"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/2192568216686752"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/230949901602400122"},{"key":"e_1_2_11_38_1","first-page":"7405","article-title":"Anatomy\u2010related risk factors for the subsidence of titanium mesh cage in cervical reconstruction after one\u2010level corpectomy","volume":"8","author":"Wu J","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200004010-00005"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2012.03.025"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2022.881979"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.905466"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-18-00832"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2013.02.038"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-4764-9"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2021.03.023"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13994","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,10]],"date-time":"2024-03-10T22:14:09Z","timestamp":1710108849000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.13994"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,5]]},"references-count":45,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1111\/os.13994"],"URL":"https:\/\/doi.org\/10.1111\/os.13994","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,5]]},"assertion":[{"value":"2023-07-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}