{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T08:23:12Z","timestamp":1771402992620,"version":"3.50.1"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To compare mid-term outcomes of plate cage systems (PC) vs. stand-alone cages (SA) in two-level ACDF for cervical spondylotic myelopathy (CSM) with cervical kyphosis, and to assess the influence of preoperative segmental kyphosis reducibility on sagittal alignment maintenance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort analyzed 130 patients (SA\u2009=\u200964, PC\u2009=\u200966) with \u226524-month follow-up. Radiographic parameters (cervical lordosis [CL], fusion segmental lordosis [FSL], disc wedge, C2 SVA) and clinical outcomes (NDI, VAS, JOA, EQ-5D, dysphagia) were assessed preoperatively, postoperatively, and at final follow-up. Patients were stratified based on preoperative reducibility of segmental kyphosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both groups showed comparable clinical improvement (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05) and fusion rates (93.8% SA vs. 95.4% PC,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.667). SA had shorter operation time (78.0\u2009\u00b1\u200911.5 vs. 86.6\u2009\u00b1\u200912.5\u2005min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), less blood loss (193.0\u2009\u00b1\u200985.6 vs. 256.7\u2009\u00b1\u2009110.3\u2005mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and lower dysphagia incidence (12.5% vs. 20.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014). However, the PC group demonstrated superior maintenance of cervical sagittal alignment in CL (13.6\u00b0\u2009\u00b1\u20090.9\u00b0 vs. 12.3\u00b0\u2009\u00b1\u20092.4\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), FSL (13.2\u00b0\u2009\u00b1\u20091.2\u00b0 vs. 11.9\u00b0\u2009\u00b1\u20092.9\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), and disc wedge (10.2\u00b0\u2009\u00b1\u20091.3\u00b0 vs. 8.9\u00b0\u2009\u00b1\u20092.6\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) at follow-up, particularly in patients with non-reducible kyphosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SA offers operative efficiency advantages, while PC is more effective in maintaining sagittal alignment, especially in rigid kyphosis. PC is recommended for patients with non-reducible cervical kyphosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1749161","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T07:31:59Z","timestamp":1771399919000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison between plate cage system and stand-alone cage in the treatment of cervical spondylotic myelopathy patients with cervical kyphosis: clinical and radiographic outcomes"],"prefix":"10.3389","volume":"13","author":[{"given":"Chao","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, The Shanghai Tenth People\u2019s Hospital of Tongji University","place":["Shanghai, China"]},{"name":"Department of Orthopedics, Changhai Hospital, Naval Medical University","place":["Shanghai, 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