ORIGINAL RESEARCH article
Front. Bioeng. Biotechnol.
Sec. Biomechanics
Volume 13 - 2025 | doi: 10.3389/fbioe.2025.1594016
This article is part of the Research TopicBiomechanics in Orthopaedic Diseases and Surgery, Volume IIView all 15 articles
Biomechanical Comparison of Anterior Cervical Corpectomy and Fusion, Anterior Controllable Antedisplacement and Fusion, and Anterior Cervical X-Shape-Corpectomy and Fusion in the Surgical Treatment of Ossification of the Posterior Longitudinal Ligament: A Finite Element Analysis
Provisionally accepted
- 1Fuzhou Second General Hospital, Fuzhou, China
- 2Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
- 3First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
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Background Anterior Cervical Corpectomy and Fusion (ACCF), Anterior Controllable Antedisplacement and Fusion (ACAF), and Anterior Cervical X-Shape-Corpectomy and Fusion (ACXF) have been shown to achieve similar decompression outcomes in the treatment of ossification of the posterior longitudinal ligament. However, the potential biomechanical differences remain unclear. Methods Finite element models of the cervical spine (C3-C7) were constructed to simulate ACCF, ACAF, and ACXF. Compare the ranges of motion (ROMs), von Mises stresses in the fixation systems and cortical endplates, and adjacent intervertebral disc pressures (IDPs) under loading conditions. Results Postoperatively, ROMs in the fusion area were significantly restricted, with ACAF exhibiting the most severe, followed by ACCF, while ACXF showed the lightest. Peak stresses in the internal fixation systems were highest in ACCF, particularly within the fusion devices. The cages in ACAF experienced lower stress than those in ACXF, whereas the screws showed the opposite trend. ACCF had the highest cortical endplate stresses, while ACXF had the lowest adjacent IDPs. Conclusion ACAF and ACXF demonstrate superior biomechanical properties in terms of stability, reduced internal fixation system risk, resistance to subsidence, and lower incidence of adjacent segment disease. As a result, they may serve as viable alternatives to ACCF in certain cases.
Keywords: Anterior cervical corpectomy and fusion, Anterior controllable antedisplacement and fusion, AnteriorCervical X-Shape-Corpectomy and Fusion, Ossification of the posterior longitudinal ligament, Finiteelement
Received: 15 Mar 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Lian, Xue, Sun, Chen, Zeng, Chen and Xue. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jing-lai Xue, xuejinglai@163.com
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