{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:27:43Z","timestamp":1787776063363,"version":"build-2784847793"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anterior cervical discectomy and fusion (ACDF) is a common surgery for patients with degenerative cervical disease and current interbody spacers utilized vary based on material composition, structure, and angle of lordosis. Currently, there is a lack of literature comparing subsidence rates or long-term radiographic outcomes with hyperlordotic and standard lordotic spacers. This study compares long-term radiographic outcomes, subsidence rate, and rate of fusion in patients who underwent ACDF with hyperlordotic or standard interbody placement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Patients who underwent 1\u20133-level ACDF with either a standard lordosis or hyperlordotic interbody were included. Standard radiographs were evaluated for C2\u20137 lordosis (CL), sagittal vertical axis, C2 slope (C2S), T1 slope (T1S), subsidence rate, and fusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Forty-five patients underwent ACDF with hyperlordotic interbody placement and after a 1:1 propensity match with standard lordotic patients, 90 patients were included. 1-year postoperative radiographs demonstrated the hyperlordotic cohort achieved higher CL (15.3\u00b0 \u00b1 10.6\u00b0 vs. 9.58\u00b0 \u00b1 8.88\u00b0;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.007). The change in CL (8.42\u00b0 \u00b1 9.42\u00b0 vs. 0.94\u00b0 \u00b1 8.67\u00b0;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), change in C2S (\u22124.02\u00b0 \u00b1 6.68\u00b0 vs. \u22121.11\u00b0 \u00b1 5.42\u00b0;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.026), and change in T1S (3.49\u00b0 \u00b1 7.30\u00b0 vs. 0.04\u00b0 \u00b1 6.86\u00b0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.008) between pre- and postoperative imaging were larger in the hyperlordotic cohort. There was no difference in overall subsidence (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.183) and rate of fusion (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.353) between the cohorts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Hyperlordotic spacer placement in ACDF can provide increased CL compared to standard lordosis spacers, which can be considered for patients requiring restoration or maintenance of CL following ACDF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jcvjs.jcvjs_116_24","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T05:01:08Z","timestamp":1736917268000},"page":"475-481","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Radiographic outcomes and subsidence rate in hyperlordotic versus standard lordotic interbody spacers in patients undergoing anterior cervical discectomy and fusion"],"prefix":"10.4103","volume":"15","author":[{"given":"Rajkishen","family":"Narayanan","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas B.","family":"Pohl","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Dalton","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunsoo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa","family":"Tomlak","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Labarbiera","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meryem","family":"Guler","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Sawicki","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian I.","family":"Fras","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark F.","family":"Kurd","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Mangan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian David","family":"Kaye","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A.","family":"Canseco","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan S.","family":"Hilibrand","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander R.","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K.","family":"Kepler","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory D.","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, 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