{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T05:15:41Z","timestamp":1793855741248,"version":"4.6.1"},"reference-count":29,"publisher":"Asian Spine Journal (ASJ)","issue":"5","license":[{"start":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T00:00:00Z","timestamp":1646956800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Boca Raton Regional Hospital Foundation","award":["SP 19-579"],"award-info":[{"award-number":["SP 19-579"]}],"id":[{"id":"https:\/\/ror.org\/01phhgk62","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["asianspinejournal.org"],"crossmark-restriction":true},"short-container-title":["Asian Spine J"],"published-print":{"date-parts":[[2022,10,31]]},"abstract":"<jats:p>Study Design: This study compares four cervical endplate removal procedures, validated by finite element models.Purpose: To characterize the effect of biomechanical strength and increased contact area on the maximum von Mises stress, migration, and subsidence between the cancellous bone, endplate, and implanted cage.Overview of Literature: Anterior cervical discectomy and fusion (ACDF) has been widely used for treating patients with degenerative spondylosis. However, no direct correlations have been drawn that incorporate the impact of the contact area between the cage and the vertebra\/endplate.Methods: Model 1 (M1) was an intact C2C6 model with a 0.5 mm endplate. In model 2 (M2), a cage was implanted after removal of the C4\u2013C5 and C5\u2013C6 discs with preservation of the osseous endplate. In model 3 (M3), 1 mm of the osseous endplate was removed at the upper endplate. Model 4 (M4) resembles M3, except that 3 mm of the osseous endplate was removed.Results: The range of motion (ROM) at C2C6 in the M2\u2013M4 models was reduced by at least 9\u00ba compared to the M1 model. The von Mises stress results in the C2C3 and C3C4 interbody discs were significantly smaller in the M1 model and slightly increased in the M2\u2013M3 and M3\u2013M4 models. Migration and subsidence decreased from the M2\u2013M3 model, whereas further endplate removal increased the migration and subsidence as shown in the transition from M3 to M4.Conclusions: The M3 model had the least subsidence and migration. The ROM was higher in the M3 model than the M2 and M4 models. Endplate preparation created small stress differences in the healthy intervertebral discs above the ACDF site. A 1 mm embedding depth created the best balance of mechanical strength and contact area, resulting in the most favorable stability of the construct.<\/jats:p>","DOI":"10.31616\/asj.2021.0424","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T21:12:20Z","timestamp":1646860340000},"page":"615-624","update-policy":"https:\/\/doi.org\/10.31616\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Biomechanical Study of Cervical Endplate Removal on Subsidence and Migration in Multilevel Anterior Cervical Discectomy and Fusion"],"prefix":"10.31616","volume":"16","author":[{"given":"Maohua","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudy","family":"Paul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen Z.","family":"Shapiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Doulgeris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy E.","family":"O\u2019Connor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Tay","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank D.","family":"Vrionis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16744","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2021.01.015"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3171\/spi\/2008\/8\/5\/420"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-006-0284-8"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2007.05.011"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-003-0539-6"},{"key":"ref6","first-page":"903","volume-title":"Subsidence and its effect on the anterior plate stabilization in the course of cervical spondylodesis. 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