{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:30:19Z","timestamp":1791217819715,"version":"4.1.0"},"reference-count":40,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T00:00:00Z","timestamp":1682726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The combined anterior\u2013posterior approach has shown good clinical outcomes for multilevel cervical diseases. This work describes the biomechanical advantage of cervical-pedicle-screw fixation over lateral-mass-screw fixation in combined anterior\u2013posterior cases. Method: Seventy-six patients who received combined cervical surgery from June 2013 to December 2020 were included. The patients were divided into two groups: the lateral-mass-screw group (LMS) and the pedicle-screw group (PPS). Radiological outcomes were assessed with lateral cervical spine X-rays for evaluating sagittal alignment, subsidence, and bone remodeling. Results: At 1 year postoperatively, the numbers of patients whose C2\u2013C7 cervical lordosis was less than 20 degrees decreased by more in the PPS group (p-value = 0.001). The amount of vertical-length change from immediately to 1 year postsurgery was less in the PPS group than in the LMS group (p-value = 0.030). The mean vertebral-body-width change was larger in the PPS group than in the LMS group during 3 months to 1 year postsurgery (p-value = 0.000). Conclusions: In combined anterior\u2013posterior cervical surgery cases, maintenance of cervical lordosis and protection of the vertebral body from subsidence were better with the pedicle-screw fixation. More bone remodeling occurred when using the pedicle-screw fixation method.<\/jats:p>","DOI":"10.3390\/jcm12093201","type":"journal-article","created":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T12:10:03Z","timestamp":1682943003000},"page":"3201","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Assessment of Biomechanical Advantages in Combined Anterior\u2013Posterior Cervical Spine Surgery by Radiological Outcomes: Pedicle Screws over Lateral Mass Screws"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8993-0161","authenticated-orcid":false,"given":"Sang-Ho","family":"Kim","sequence":"first","affiliation":[{"name":"Orthopedic Department, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-hyeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Dangjin 9988 Hospital, Dangjin-si 31784, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Won","family":"Kwon","sequence":"additional","affiliation":[{"name":"Orthopedic Department, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hak-Sun","family":"Kim","sequence":"additional","affiliation":[{"name":"Orthopedic Department, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong-Hwan","family":"Moon","sequence":"additional","affiliation":[{"name":"Orthopedic Department, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung-Soo","family":"Suk","sequence":"additional","affiliation":[{"name":"Orthopedic Department, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7235-4981","authenticated-orcid":false,"given":"Byung-Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Orthopedic Department, College of Medicine, Yonsei University, Seoul 03722, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.jocn.2008.07.070","article-title":"Outcomes for combined anterior and posterior surgical approaches for patients with multisegmental cervical spondylotic myelopathy","volume":"16","author":"Konya","year":"2009","journal-title":"J. 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