{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:23:33Z","timestamp":1777659813185,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,5,5]],"date-time":"2024-05-05T00:00:00Z","timestamp":1714867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,5,5]],"date-time":"2024-05-05T00:00:00Z","timestamp":1714867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2025,4]]},"abstract":"\n Study Design<\/jats:title>\n Retrospective Cohort.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to assess the easily measurable radiographic landmarks of screw-to-vertebral body ratio and changes in screw angle to identify if they are associated with early subsidence following an Anterior cervical discectomy and fusion (ACDF).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective cohort study was conducted on patients undergoing 1-3 level ACDF with allograft or PEEK cages. Preoperative, immediate postoperative, and 6-month postoperative radiographs were analyzed to measure intradiscal height (or distance between 2 vertebral bodies) as an anterior vertebral distance (AVD), middle (MVD), and posterior (PVD), screw angle, screw-to-vertebral body length ratio, and interscrew distance. Multivariate stepwise regression analyses were performed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 92 patients were included (42 single-level, 32 two-level, and 18 3-level ACDFs). In single-level ACDFs, a decrease in the caudal screw angle was associated with a decrease in AVD (=.001) and MVD (\n P<\/jats:italic>\n = .03). A decrease in the PVD was associated with a decrease in segmental lordosis (\n P<\/jats:italic>\n < .001). For two-level ACDFs, a higher caudal screw-to-body ratio was associated with a lower MVD (\n P<\/jats:italic>\n = .01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Six months following an ACDF for degenerative pathology, a decrease in the caudal screw angle was associated with an increase in radiographic subsidence at the antero-medial aspect of the disc space albeit largely subclinical. This suggests that the caudal screw angle change may serve as a reliable radiographic marker for early radiographic subsidence. Furthermore, a greater screw-to-vertebral body ratio may be protective against radiographic subsidence in two-level ACDF procedures.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/21925682241252088","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T02:35:20Z","timestamp":1714962920000},"page":"1582-1591","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Are Variable Screw Angle Change and Screw-to-Vertebral Body Ratio Associated With Radiographic Subsidence Following Anterior Cervical Discectomy and Fusion?"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4787-1538","authenticated-orcid":false,"given":"Philip K.","family":"Louie","sequence":"first","affiliation":[{"name":"Virginia Mason Medical 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