Objective Pseudarthrosis and adjacent segment degeneration (ASD) are 2 common complications after multilevel anterior cervical discectomy and fusion (ACDF). We aim to identify the potential biomechanical factors contributing to pseudarthrosis and ASD following 3-level ACDF using a cervical spine finite element model (FEM).
Methods A validated cervical spine FEM from C2 to C7 was used to study the biomechanical factors in cervical spine intervention. The FEM model was used to simulate a 3-level ACDF with intervertebral spacers and anterior cervical plating with screw fixation from C4 to C7. The model was then constrained at the inferior nodes of the T1 vertebra, and physiological loads were applied at the top vertebra. The pure moment load of 2 Nm was applied in flexion, extension, and lateral bending. A follower axial force of 75 N was applied to reproduce the weight of the cranium and muscle force, was applied using standard procedures. The motion-controlled hybrid protocol was utilized to comprehend the adjustments in the spinal biomechanics.
Results Our cervical spine FEM demonstrated that the cranial adjacent level (C3–4) had significantly more increase in range of motion (ROM) (+90.38%) compared to the caudal adjacent level at C7–T1 (+70.18%) after C4–7 ACDF, indicating that the cranial adjacent level has more compensatory increase in ROM than the caudal adjacent level, potentially predisposing it to earlier ASD. Within the C4–7 ACDF construct, the C6–7 level had the least robust fixation during fixation compared to C4–5 and C5–6, as reflected by the smallest reduction in ROM compared to intact spine (-71.30% vs. -76.36% and -77.05%, respectively), which potentially predisposes the C6–7 level to higher risk of pseudarthrosis.
Conclusion Biomechanical analysis of C4–7 ACDF construct using a validated cervical spine FEM indicated that the C3–4 has more compensatory increase in ROM compared to C7–T1, and C6–7 has the least robust fixation under physiological loads. These findings can help spine surgeons to predicate the areas with higher risks of pseudarthrosis and ASD, and thus developing corresponding strategies to mitigate these risks and provide appropriate preoperative counseling to patients.
Citations
Citations to this article as recorded by
Does Aspirin Use Influence Rates of Pseudoarthrosis After Anterior Cervical Discectomy and Fusion? Kevin T. Kim, Ziam Khan, Joseph Stains, Timothy Chryssikos Global Spine Journal.2026; 16(4): 1938. CrossRef
Finite Element Study of Anterior Cervical Discectomy and Fusion Constructs Near Cervicothoracic Junction—Is T2 Modeling Necessary? J. A. Febin Chris Asir, D. Davidson Jebaseelan, Aju Bosco, Balaji Harinathan, Narayan Yoganandan Journal of Biomechanical Engineering.2026;[Epub] CrossRef
Biomechanical Analysis Comparison of Different Cervical Posterior Screw Fixation Techniques: A Finite Element Study Joonoh Seo, Woo-Seok Jung, Tae Hyun Park, Sung-Jae Lee, Ji-Won Kwon, Kyung-Soo Suk, Byung Ho Lee Neurospine.2026; 23(1): 187. CrossRef
Approach to assess the effect of sagittal cervical alignment on three-dimensional movement of the cervical spine in spondylosis patients Jiangpeng Gu, Xiaoman Wang, Xujing Chen, Zunan Dong, Wei Guo, Wei Feng, Chaoqun Ye, Fei Wang, Xiaomin Liu European Spine Journal.2026;[Epub] CrossRef
Evolving trends in anterior cervical spine surgery: a decade-long shift towards standalone constructs Nolan M. Reinhart, Jackson P. Tate, Zachary Salas, William F. Sherman, Mathew Cyriac Current Orthopaedic Practice.2026;[Epub] CrossRef
MRI after Cervical Spine Decompression and Fusion Surgery: Technical Considerations, Expected Findings, and Complications Frederik Abel, Ek T. Tan, Yenpo Lin, J. Levi Chazen, Darren R. Lebl, Darryl B. Sneag Radiology.2025;[Epub] CrossRef
Prediction of heterotopic ossification on the cervical spine with offset of the artificial disc – A finite element study Balaji Harinathan, Davidson Jebaseelan, Hemkar Sharma, Lenin Babu, Rajasekaran Shanmuganathan, Narayan Yoganandan Medical Engineering & Physics.2025; 141: 104356. CrossRef
Fusion Sequence and Risk Factors for Pseudarthrosis in Multilevel Anterior Cervical Discectomy and Fusion Hyun Woong Mun, Jong Joo Lee, Hyun Chul Shin, Tae-Hwan Kim, Seok Woo Kim, Jae Keun Oh Neurosurgery.2025; 97(5): 1153. CrossRef
A First Step Toward Patient-Specific Cervical Spine Finite Element Modeling Approaches for Military and Civilian Applications Narayan Yoganandan, Aditya Vedantam, Balaji Harinathan, Davidson Jebaseelan, Amit Bagchi Journal of Engineering and Science in Medical Diagnostics and Therapy.2025;[Epub] CrossRef
Development of a CT-based 3D finite element model of the whole cervical spine with occiput: Insights into sagittal balance, disc pressure, and facet joint forces Hu Chen, Lu Cao, Yinghua He, Hao Sun, Qiang Tu World Neurosurgery: X.2025; 28: 100543. CrossRef
Finite element analysis of a new preoperative traction for cervical kyphosis: suspensory traction Hongyu Chen, Tianchi Wu, Shengfa Pan, Li Zhang, Yanbin Zhao, Xin Chen, Yu Sun, William W. Lu, Feifei Zhou Medical & Biological Engineering & Computing.2024; 62(9): 2867. CrossRef
Biomechanical Analysis of Hybrid Artificial Discs or Zero-Profile Devices for Treating 1-Level Adjacent Segment Degeneration in ACDF Revision Surgery Weishi Liang, Yihan Yang, Bo Han, Duan Sun, Peng Yin, Yong Hai Neurospine.2024; 21(2): 606. CrossRef
Radiographic Characteristics of Caudal Segment in Multilevel Anterior Cervical Discectomy and Fusion: The Bony Buttress Formation Chang Hwa Ham, Joo Han Kim, Youn-Kwan Park, Woo-Keun Kwon, Hong Joo Moon Neurospine.2024; 21(4): 1241. CrossRef
Comparing adjacent segment biomechanics between anterior and posterior cervical fusion using patient-specific finite element modeling Balaji Harinathan, Davidson Jebaseelan, Narayan Yoganandan, Aditya Vedantam Asian Spine Journal.2024; 18(6): 777. CrossRef
Spinal Cord Stress After Anterior Cervical Diskectomy and Fusion: Results from a Patient-Specific Finite Element Model Aditya Vedantam, Yuvaraj Purushothaman, Balaji Harinathan, Stephen Scripp, Matthew D. Budde, Narayan Yoganandan Annals of Biomedical Engineering.2023; 51(5): 1040. CrossRef
Biomechanik der HWS und ihre anatomischen Grundlagen Sebastian Decker, Sabine Roth, Ralph Gaulke, Stephan Sehmisch, Heiko Koller Die Wirbelsäule.2023; 07(02): 94. CrossRef
Comparing zero-profile and conventional cage and plate in anterior cervical discectomy and fusion using finite-element modeling Chang-Hwan Ahn, Sungwook Kang, Mingoo Cho, Seong-Hun Kim, Chi Heon Kim, Inbo Han, Chul-Hyun Kim, Sung Hyun Noh, Kyoung-Tae Kim, Jong-Moon Hwang Scientific Reports.2023;[Epub] CrossRef
Objective To examine existing literature and pool the data to determine the relative odds ratio of “adding-on” (AO) based on various reported criteria for lower instrumented vertebra (LIV) selection in Lenke type 1A and 2A curves.
Methods Using electronic databases, studies reporting on AO and LIV selection in Lenke type 1A and 2A curves were identified. Studies were excluded if they failed to meet the following criteria: ≥ 30 patients, Lenke type 1A or 2A curves, thoracic-only fusions, and inclusion of outcome differences in AO and non-AO groups. Review articles, letters, and case reports were excluded.
Results Six studies were identified reporting on 732 patients with either Lenke type 1A or 2A curves treated with thoracic-only fusions. Five different landmarks were used for LIV selection in these studies including the stable vertebra (SV) -1, end vertebra (EV) +1, neutral vertebra (NV), touched vertebra (TV), and substantially touched vertebra (STV) versus nonsubstantially touched vertebra (nSTV) +1. The pooled odds ratios of AO for choosing LIV at levels above the afore landmarks (i.e. , ending the construct “short”) versus at the landmarks were 2.59 (SV-1), 2.43 (EV+1), 3.05 (NV), 3.40 (TV), and 4.52 (STV/nSTV+1), all at 95% confidence interval.
Conclusion Five landmarks shared a similar characteristic in that the incidence of AO was significantly higher if the LIV was proximal to the chosen landmark. In addition, choosing STV/(nSTV+1) as the LIV have the lowest absolute risk of AO and the greatest risk reduction. If additional levels were fused (i.e. , LIV distal to the landmark), there was no statistically significant benefit in further reducing the risk of AO. Selection of the optimal LIV is a complex issue and spine surgeons must balance the risk of AO with the need for motion preservation in young patients.
Citations
Citations to this article as recorded by
Lowest Instrumented Vertebra (LIV) Index as a Supplemental Indicator to Lastly Touched Vertebra for Selection of the Fusion Level in Main Thoracic Adolescent Idiopathic Scoliosis I-Hsin Chen, Chih-Wei Chen, Chuan-Ching Huang, Jui-Yo Hsu, Po-Yao Wang, Yuan-Fuu Lee, Yu-Cheng Yeh, Po-Liang Lai, Ming-Hsiao Hu, Shu-Hua Yang Global Spine Journal.2026; 16(2): 956. CrossRef
Advances in fusion level selection and surgical approaches for adolescent idiopathic scoliosis based on the Lenke classification system: a narrative review Ruiyuan Chen, Yu Xi, Tianyi Wang, Aobo Wang, Ziqian Ma, Minghui Liang, Shuo Yuan, Lei Zang, Ning Fan BMC Surgery.2026;[Epub] CrossRef
The Impact of the Lowest Instrumented Vertebra on the Correction of the Minor Curve During Selective Fusion in Patients With Adolescent Idiopathic Scoliosis Max Prost, Philip Denz, Joachim Windolf, Markus Rafael Konieczny Clinical Spine Surgery.2025; 38(3): E135. CrossRef
The benefits of touched vertebra concept for the selection of the lowest instrumented vertebra in thoracic curves of adolescent idiopathic scoliosis Dong-Gune Chang, Lawrence G. Lenke, Hong Jin Kim, Javier Pizones, René Castelein, Per D. Trobisch, Kota Watanabe, Kee-Yong Ha, Se-Il Suk European Spine Journal.2025; 34(1): 234. CrossRef
A mathematical model for estimating the intraoperative lowest instrumented vertebra (LIV) tilt angle using preoperative supine left side-bending (LSB) radiographs in adolescent idiopathic scoliosis (AIS) patients with lenke type 1 and 2 non-AR curves Mun Keong Kwan, Sin Ying Lee, Sze Khiong Fam, Yee Wern Evonne Tan, Chun Hong Ngan, Saturveithan Chandirasegaran, Chee Kidd Chiu, Chris Yin Wei Chan European Spine Journal.2025; 34(2): 610. CrossRef
Postoperative forward flexion loss in Adolescent Idiopathic Scoliosis: How it relates to the lowest instrumented vertebra and function Sebastiaan Schelfaut, Thijs Ackermans, Fred Ruythooren, Tom Leppens, Pierre Moens, Anja Van Campenhout, Lieven Moke, Lennart Scheys Gait & Posture.2025; 122: 10. CrossRef
Fenómeno Adding-on en pacientes con escoliosis idiopática del adolescente tratados quirúrgicamente en un hospital de ortopedia de referencia José Luis García-Navarro, Jorge Quiroz-Williams, Elías Kaleb Rojero-Gil, Suemmy Gaytán-Fernández, Rubén Romero-Méndez, José Pedro Martínez-Asención, Rodolfo Gregorio Barragán-Hervella, Gabriel Jiménez-Armenta Cirugía de Columna.2025; 3(4): 260. CrossRef
Radiographic and clinical outcomes after definitive spine fusion for skeletally immature patients with idiopathic scoliosis Adam A. Jamnik, Emmanouil Grigoriou, Allen Kadado, Chan-Hee Jo, Nathan Boes, David Thornberg, Dong-Phuong Tran, Brandon Ramo Spine Deformity.2024; 12(1): 149. CrossRef
Measurement of Postoperative Apical Vertebral Rotation Using Radiographic Images in Adolescent Idiopathic Scoliosis-Quantitative Evaluation Using Inverse Trigonometric Functions Shun Okuwaki, Toshiaki Kotani, Shuhei Ohyama, Shuhei Iwata, Tsuyoshi Sakuma, Yasushi Iijima, Tsutomu Akazawa, Kazuhide Inage, Yasuhiro Shiga, Shohei Minami, Seiji Ohtori, Masashi Yamazaki Spine Surgery and Related Research.2024; 8(2): 203. CrossRef
Factores predisponentes a adding-on en pacientes con escoliosis idiopática del adolescente en curvas tipo I y II de Lenke José Antonio Canales Nájera, Antonio Hurtado Padilla, Luis Antonio Guzmán Amoroso Cirugía de Columna.2024; 2(3): 151. CrossRef
Three- instead of two-dimensional evaluation of key parameters alters the choice of the lowest instrumented vertebra in Lenke 1 and 2 AIS patients Sebastiaan Schelfaut, Pierre Moens, Thomas Overbergh, Steven Cornelis, Anja Van Campenhout, Lieven Moke, Lennart Scheys, Thijs Ackermans Spine Deformity.2023; 11(5): 1137. CrossRef
Minimally Invasive Posterior Spinal Nonfusion Surgery in Patients With Adolescent Idiopathic Scoliosis Using a Bipolar One-Way Self-Expanding Rod System: Protocol for a Single-Center Clinical Cohort Study Anne Mareille Post, Hanneke I Berends, Barend J van Royen JMIR Research Protocols.2023; 12: e47222. CrossRef
The Last Touched Vertebra on Supine Radiographs Can Be the Optimal Lower Instrumented Vertebra in Adolescent Idiopathic Scoliosis Patients Do-Hyoung Kim, Seung-Jae Hyun, Chang-Hyun Lee, Ki-Jeong Kim Neurospine.2022; 19(1): 236. CrossRef
Surgical outcome of minimal invasive oblique lateral interbody fusion with percutaneous pedicle screw fixation in the treatment of adult degenerative scoliosis Jun Seok Lee, Dong Wuk Son, Su Hun Lee, Soon Ki Sung, Sang Weon Lee, Geun Sung Song, Young Ha Kim, Chang Hwa Choi Medicine.2022; 101(48): e31879. CrossRef
CORR Insights®: Is the Combination of Convex Compression for the Proximal Thoracic Curve and Concave Distraction for the Main Thoracic Curve Using Separate-rod Derotation Effective for Correcting Shoulder Balance and Thoracic Kyphosis? Kent A. Reinker Clinical Orthopaedics & Related Research.2021; 479(6): 1357. CrossRef
C1 stenosis is often an easily missed cause for cervical myelopathy. The vast majority of cervical myelopathy occurs in the subaxial cervical spine. The cervical canal is generally largest at C1/2, explaining the relatively rare incidence of neurological deficits in patients with odontoid fractures. However, some subjects have anatomical anomalies of the atlas, which may cause stenosis and result in clinical symptoms similar to subaxial cord compression. Isolated pure atlas hypoplasia leading to stenosis is quite rare and may be associated with other anomalies, such as atlas clefts or transverse ligament calcification. It may also be more commonly associated with syndromic conditions such as Down or Turner syndrome. Although the diagnosis can be easily made with a cervical magnetic resonance imaging, the C3/2 spinolaminar test using a lateral cervical plain radiograph is a useful and sensitive tool for screening. Surgical treatment with a C1 laminectomy is generally necessary and any atlantoaxial or occipito-atlanto instability must be treated with spinal stabilization and fusion.
Citations
Citations to this article as recorded by
A review and commentary on congenital anomalies of the craniocervical junction Aaron S McAllister, Eric A Sribnick Pediatric Radiology.2026; 56(6): 1254. CrossRef
Unilateral open-door laminoplasty involving C1 for developmental atlantal canal stenosis combined with multilevel cervical stenosis: a case report Yanjun Yang, Yuwei Chen, Tonglei Chen, Zhanjun Yan, Feng Yang BMC Surgery.2026;[Epub] CrossRef
Prospective Analysis of Day-One Postoperative MRI Following Cervical Decompression for Cervical Myelopathy: Insights into Residual Compression and Signal Changes Bharat R Dave, Abhijith Anil, Sandesh Agrawal, Mahesh Sagar, Mirant B Dave, Mikeson Panthackel, Shivanand C Mayi, Ravi Ranjan Rai, Ajay Krishnan, Arjit Vashishtha, Amritesh Singh Cureus.2025;[Epub] CrossRef
Modified Atlantoaxial Arthrodesis Technique for Atlantoaxial Instability via Intraarticular Autografting Using Structural Iliac Bone: Technical Nuances and Case Series Koichi Iwasaki, Hirokuni Hashikata, Kazushi Kitamura, Isao Sasaki, Hiroki Toda World Neurosurgery.2024; 190: e144. CrossRef
C1 Cervical Stenosis Causing Chronic Neck Pain and Ataxia: The Importance of Physical Examination and Radiographic Imaging Danni Lu, Jason Kessler, Zuhair Khan, Richard Lau American Journal of Physical Medicine & Rehabilitation.2023; 102(6): e87. CrossRef
Effect of C1 Single‐door Laminoplasty on Symptomatic Atlas Canal Stenosis Linwei Chen, Xiuliang Zhu, Bin He, Qixin Chen, Fangcai Li Orthopaedic Surgery.2022; 14(10): 2757. CrossRef
Symptomatic Atlas Hypoplasia in a Latin-American Patient: Case Report and Literature Review Matias Pereira Duarte, Gasto Camino Willhuber, Matias Petracchi, Marcelo Gruenberg, Carlos Alberto Sola JAAOS: Global Research and Reviews.2021; 5(5): e21.00041. CrossRef
The Aging Population Faces Increased Risk for Musculoskeletal Pathologies: The Problematic Atlas-Axis Instability Antonia Nituleasa, Elizabeth D Liu, Ryan F Amidon, Christ Ordookhanian, Paul Kaloostian Cureus.2021;[Epub] CrossRef
Imagerie de la charnière cervico-occipitale : malformations J.-L. Dietemann, R. Sanda, A. Fitsiori, M.-I. Vargas, A. Gangi EMC - Radiologie et imagerie médicale - Musculosquelettique - Neurologique - Maxillofaciale.2021; 40(4): 1. CrossRef
Objective This retrospective cohort study seeks to identify risk factors associated with complications following posterior cervical laminectomy and fusion (PCLF) surgery.
Methods Adults undergoing PCLF from 2012 through 2018 at a single center were identified. Demographic and radiographic data, surgical characteristics, and complication rates were compared. Multivariate logistic regression models identified independent predictors of complications following surgery.
Results A total of 196 patients met the inclusion criteria and were included in the study. The medical, surgical, and overall complication rates were 10.2%, 23.0%, and 29.1% respectively. Risk factors associated with medical complications in multivariate analysis included impaired ambulation status (odds ratio [OR], 2.27; p=0.02) and estimated blood loss over 500 mL (OR, 3.67; p=0.02). Multivariate analysis revealed preoperative narcotic use (OR, 2.43; p=0.02) and operative time (OR, 1.005; p=0.03) as risk factors for surgical complication, whereas antidepressant use was a protective factor (OR, 0.21; p=0.01). Overall complication was associated with preoperative narcotic use (OR, 1.97; p=0.04) and higher intraoperative blood loss (OR, 1.0007; p=0.03).
Conclusion Preoperative narcotic use and estimated blood loss predicted the incidence of complications following PCLF for CSM. Ambulation status was a significant predictor of the development of a medical complication specifically. These results may help surgeons in counseling patients who may be at increased risk of complication following surgery.
Citations
Citations to this article as recorded by
Risk factors of significant intraoperative blood loss in unilateral expansive open-door cervical laminoplasty for cervical compressive myelopathy: A retrospective observational study Hailong Yu, Hong Yuan, Zhihao Zhang, Xinyuan Zhao, Bin Zheng, Xiaoyu Wang, Yin Hu, Hongwei Wang Medicine.2026; 105(20): e48869. CrossRef
Minimally Invasive Surgical Technique through a Natural Anatomical Corridor for C1-C2 Screw Fixation Andres Mendez-Gutierrez, Mariana Agudelo-Arrieta, Miguel Enrique Berbeo, Roberto Diaz-Orduz Journal of Minimally Invasive Spine Surgery and Technique.2023; 8(1): 55. CrossRef
Risk Factors for Significant Intraoperative Blood Loss during Anterior Cervical Decompression and Fusion for Degenerative Cervical Diseases Hong Yuan, Yuanhang Zhao, Yin Hu, Zhonghua Liu, Yu Chen, Hongwei Wang, Hailong Yu, Liangbi Xiang Orthopaedic Surgery.2023; 15(11): 2822. CrossRef
Laminectomy alone versus laminectomy with lateral mass screw fixation in the treatment of multisegment cervical spinal canal stenosis: a comparative analysis Hany Elkholy, Mohamed Ahmed El Tabl, Osama Saber El Sherif Egyptian Journal of Neurosurgery.2023;[Epub] CrossRef
Complications in posterior cervical spine surgery Julian G. Lugo-Pico, John G. Heller Seminars in Spine Surgery.2022; 34(1): 100921. CrossRef
Smoking Is an Independent Risk Factor for 90-Day Readmission and Reoperation Following Posterior Cervical Decompression and Fusion Ryan K Badiee, Andrew K Chan, Joshua Rivera, Annette Molinaro, Dean Chou, Praveen V Mummaneni, Lee A Tan Neurosurgery.2021; 88(6): 1088. CrossRef
Benefits of Early Ambulation in Elderly Patients Undergoing Lumbar Decompression and Fusion Surgery: A Prospective Cohort Study Jie Huang, Zhan Shi, Fang‐fang Duan, Ming‐xing Fan, Shuo Yan, Yi Wei, Bing Han, Xue‐mei Lu, Wei Tian Orthopaedic Surgery.2021; 13(4): 1319. CrossRef
Due to the highly mobile nature of the cervical spine, and the fact that most magnetic resonance imagings (MRIs) and computed tomography scans are obtained only in one single position, dynamic cord compression can be an elusive diagnosis that is often missed and not well-understood. In this context, dynamic MRI (dMRI) has been utilized to improve the diagnostic accuracy of cervical stenosis. We performed a literature review on dynamic cord compression in the context of cervical spondylotic myelopathy (CSM), with particular emphasis on the role of dMRI. Cadaveric studies report that the spinal cord lengthens in flexion and the spinal canal dimension increases, whereas the spinal cord relaxes and shortens in extension and the spinal canal decreases. These changes may lead to biomechanical stress in the spinal cord with movement, especially in patients with critical cervical stenosis. The majority of the studies using dMRI in CSM reported that this imaging modality is more sensitive at detecting cervical cord compression compared to routine MRIs done in a neutral position, especially with the neck in extension. Dynamic MRI was also useful to diagnose dynamic cervical cord compression after laminectomies in patients with clinical deterioration without evident cord compression on neutral static MRI. Finally, dMRI is more sensitive in detecting stenosis in patients with CSM than in those with ossification of the posterior longitudinal ligament (OPLL), likely because OPLL patients often have a more limited range of motion than CSM patients. Thus, dMRI is a promising new tool that can help spine surgeons in diagnosing and treating CSM.
Citations
Citations to this article as recorded by
Intramedullary Strain During Neck Extension is Associated with Microstructural Spinal Cord Injury in Degenerative Cervical Myelopathy Mahmudur Rahman, Karthik Banurekha Devaraj, Balaji Harinathan, Omkar Chauhan, Matthew Budde, Narayan Yoganandan, Aditya Vedantam Annals of Biomedical Engineering.2026; 54(7): 2015. CrossRef
Early Diagnosis of Degenerative Cervical Myelopathy: A Systematic Review of Current Evidence Fabrizio Russo, Paolo Brigato, Giuseppe Francesco Papalia, Nicolò Fazzi, Pietro Foglia, Gianluca Vadalà, Rocco Papalia, Vincenzo Denaro Global Spine Journal.2026;[Epub] CrossRef
Does Cervical Cord Compression Preclude Lateral Suboccipital Positioning in Cerebellopontine Angle Tumor Excision? Sharath Krishnaswami, Brenda Paulson, Dheeraj Masapu, Satish Rudrappa, Huda Fathima Journal of Acute Care, Trauma and Emergency Medicine.2026; 2(1): 23. CrossRef
Beyond Cord Compression: Instability as a Major Driver for Neurological Deficit in Active Thoracic Spinal Tuberculosis Harikrishna Raghuraj Ramasamy, Gnanaprakash Gurusamy, Sri Vijay Anand K S, Ajoy Prasad Shetty, Rishi Mugesh Kanna, Mogan Kaviprawin, Shanmuganathan Rajasekaran Global Spine Journal.2026;[Epub] CrossRef
Preoperative Disc Height as a Prognostic Factor in Laminoplasty for Cervical Spondylotic Myelopathy with Degenerative Spondylolisthesis Yuta Doi, Kiyoshi Tarukado, Kazuya Yokota, Kazu Kobayakawa, Hirokazu Saiwai, Kenichi Kawaguchi, Yasuharu Nakashima Spine Surgery and Related Research.2026; 10(3): 376. CrossRef
The impact of neck extension on intraoperative neuromonitoring alerts in cervical myelopathy: A neurophysiological analysis Omar Lubbad, Harry Spence, Paarth Sinha, Josephine Poole, Kaarthigan Masilamany, Rafiq Sheikhali, Rubeen Ahmad, Giuseppe Lambros Morassi, Nektarios K. Mazarakis Clinical Neurophysiology.2026; 190: 2111970. CrossRef
Imaging of Degenerative Cervical and Thoracic Myelopathy Tomasz Matys, Richard Mannion, Syed S. Hashmi, Mark Kotter, Tarik F. Massoud Neuroimaging Clinics of North America.2026;[Epub] CrossRef
Acute quadriplegia and death following a routine MRI for undiagnosed degenerative cervical myelopathy Cylene Yang, Oliver D. Mowforth, Amir Rafati Fard, Benjamin M. Davies, Rodney J. C. Laing British Journal of Neurosurgery.2025; 39(2): 259. CrossRef
Extensive high signal intensity area on T2-weighted MRI in the spinal cord is associated with spinal segment instability and potentially worse clinical outcomes in patients with cervical spondylotic myelopathy Naoki Yamaguchi, Kazuya Kitamura, Kenta Suzuki, Shin Obara, Haruo Sasaki, Takahiro Nakagawa, Akimasa Yasuda, Kazuhiro Chiba, Keisuke Horiuchi Journal of Orthopaedic Science.2025; 30(6): 1013. CrossRef
T2-weighted MRI high signal in cervical spondylotic myelopathy is associated with dynamic change Xiangzhen Kong, Zhenchuan Liu, Kangle Song, Keyu Pan, Yuanqiang Zhang, Jianlu Wei, Lei Cheng Journal of Orthopaedic Surgery and Research.2025;[Epub] CrossRef
Evaluating the pivotal role of MRI in craniocervical junction injury diagnosis: A case report Mahyar Daskareh, Saeid Esmaeilian, Elham Rahmanipour, Mohammad Ghorbani Medicine.2025; 104(21): e42154. CrossRef
Quantitative assessment of asymptomatic spinal cord compression using MRI: a multi-center study Ali F. Khan, Sanaa Hameed, Alaa Baha, Fauziyya Muhammad, Grace Haynes, Amber Dastgir, Suresh K. Gulla, Hakeem J. Shakir, Michael L. Rohan, Yasin Y. Dhaher, Zachary A. Smith GeroScience.2025; 47(6): 6749. CrossRef
Weight-bearing MRI of the cervical spine: A scoping review of clinical utility and emerging applications Jonathan Verderame, Muhammad Shakib Arslan, Farhan Mukhtar, Zaheer Abbas European Journal of Radiology Open.2025; 15: 100694. CrossRef
Use of Flexion-Extension MRI to Reveal Occult Spondylotic Compression in Undifferentiated Cervical Myelopathies With Cord T2 Hyperintensity Santiago Martinez Sosa, Karl N. Krecke, Stephanie B. Syc-Mazurek, William E. Krauss, Karen Truitt, Michelle J. Clarke, Eoin P. Flanagan Neurology Clinical Practice.2025;[Epub] CrossRef
Flexion K-Line Status Predicts Surgical Strategy in Multilevel Cervical Ossification of the Posterior Longitudinal Ligament: A Multicenter Comparison of Laminoplasty and Laminectomy With Fusion Jun Jae Shin, Sun Joon Yoo, Se Jun Park, Dong Kyu Kim, Hyun Jun Jang, Bong Ju Moon, Kyung Hyun Kim, Jeong Yoon Park, Sung Uk Kuh, Dong Kyu Chin, Keun Su Kim, Yong Eun Cho, Chang Kyu Lee, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Joongkyum Shin, Yoon Ha Neurospine.2025; 22(4): 937. CrossRef
Favorable cervical extension capacity preventing loss of cervical lordosis after laminoplasty due to spontaneous restoration of initial lordosis Xiaofei Cheng, Zhiqian Chen, Xiaojiang Sun, Changqing Zhao, Jie Zhao The Spine Journal.2024; 24(1): 94. CrossRef
Dynamic Flexion-Extension Magnetic Resonance Imaging of the Cervical Spine: An Evolutionary Tool for Diagnosis and Management of Cervical Spondylotic Myelopathy Ali Mahdavi, Sina Rasti World Neurosurgery.2024; 184: 138. CrossRef
Radiological and Clinical Significance of Cervical Dynamic Magnetic Resonance Imaging for Cervical Spondylotic Myelopathy Jun Jae Shin, Sun Joon Yoo, Tae Woo Kim, Jae-Young So, Won Joo Jeong, Mu Ha Lee, Joongkyum Shin, Yoon Ha Neurospine.2024; 21(2): 443. CrossRef
Clinical and radiographic characteristics of increased signal intensity of the spinal cord at the vertebral body level in patients with cervical myelopathy Takuhei Kozaki, Yasutsugu Yukawa, Hiroshi Hashizume, Hiroshi Iwasaki, Shunji Tsutsui, Masanari Takami, Keiji Nagata, Ryo Taiji, Shizumasa Murata, Hiroshi Yamada Journal of Orthopaedic Science.2023; 28(6): 1240. CrossRef
Magnetic Resonance Imaging Grading Systems for Central Canal and Neural Foraminal Stenoses of the Lumbar and Cervical Spines With a Focus on the Lee Grading System Jiwoon Seo, Joon Woo Lee Korean Journal of Radiology.2023; 24(3): 224. CrossRef
Correlation and reliability of cervical sagittal alignment parameters between plain radiographs and multipositional MRI images Zhiqiang Zhou, Fanguo Lin, Yao Zhang, Zhigao Jin, Dong Liu, Yekun Deng, Xiaotong Wang, Xiaozhong Zhou Spinal Cord.2023; 61(5): 307. CrossRef
Utility of Flexion and Extension MRI for Evaluating Isolated Cervical Spinal Cord Lesions: A Case Series Zeinab Awada, Sami Saba, Asaff Harel Cureus.2023;[Epub] CrossRef
Degenerative Cervical Myelopathy: An Overview Laura M Saunders, Hushil S Sandhu, Lorcán McBride, Vindhya S Maniarasu, Samantha Taylor, Rakesh Dhokia Cureus.2023;[Epub] CrossRef
In Response to A New Orthotic Device for Maintaining Neck Flexion Following Tracheal… Nicole Molin, Erin Terreson, Ahmed M.S. Soliman The Laryngoscope.2022;[Epub] CrossRef
In Reference to A New Orthotic Device for Maintaining Neck Flexion Following Tracheal and Cricotracheal Resection Justin Ross, Gregory Postma The Laryngoscope.2022;[Epub] CrossRef
Design and ergonomic assessment of a passive head/neck supporting exoskeleton for overhead work use Ehsan Garosi, Adel Mazloumi, Amir Homayoun Jafari, Ahmadreza Keihani, Mansour Shamsipour, Ramin Kordi, Zeinab Kazemi Applied Ergonomics.2022; 101: 103699. CrossRef
The Prevalence of Degenerative Cervical Myelopathy-Related Pathologies on Magnetic Resonance Imaging in Healthy/Asymptomatic Individuals: A Meta-Analysis of Published Studies and Comparison to a Symptomatic Cohort Arkaprabha Banerjee, Oliver D. Mowforth, Aria Nouri, Alexandru Budu, Virginia Newcombe, Mark R.N. Kotter, Benjamin M. Davies Journal of Clinical Neuroscience.2022; 99: 53. CrossRef
Sensitization of Hoffmann’s sign in response to a reverse Lhermitte’s sign: a case report Gary Kearns, Jillian Bason Journal of Manual & Manipulative Therapy.2022; 30(6): 357. CrossRef
Are clinical outcomes affected by laminoplasty method and K-line in patients with cervical ossification of posterior longitudinal ligament? A multicenter study Nan Li, Sai Ma, Fangfang Duan, Yi Wei, Da He, Narihito Nagoshi, Kota Watanabe, Masaya Nakamura, Morio Matsumoto, Hyeongseok Jeon, J. J. Lee, Keung-Nyun Kim, Yoon Ha, Kenny Kwan, A. K. P. Cheung, Aaron Clark Journal of Orthopaedic Surgery and Research.2022;[Epub] CrossRef
Surgical Strategies and Perioperative Considerations for Cervical Deformity With Cerebral Palsy: A Comprehensive Review of the Literature Hyung Cheol Kim, Sung Han Oh, Jae Keun Oh, Yoon Ha Neurospine.2022; 19(4): 868. CrossRef
Laminectomy with instrumented fusion vs. laminoplasty in the surgical treatment of cervical ossification of the posterior longitudinal ligament: A multicenter retrospective study Jong Joo Lee, Hyung Cheol Kim, Hyeong Seok Jeon, Seong Bae An, Tae Woo Kim, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Do Heum Yoon, Hyun Chul Shin, Narihito Nagoshi, Kota Watanabe, Da He, Daniel J. Hoh, K. Daniel Riew, Jun Jae Shin, Yoon Ha Journal of Clinical Neuroscience.2021; 94: 271. CrossRef
Commentary on “Surgical and Functional Outcomes of Expansive Open-Door Laminoplasty for Patients With Mild Kyphotic Cervical Alignment” Dongwuk Son Neurospine.2021; 18(4): 758. CrossRef
Encephalic Symptoms Leading to Diagnosis of Cervical Myelopathy Alex Bengtsson, Lance M. Mabry JOSPT Cases.2021; 1(2): 87. CrossRef
Surgical Strategies for Cervical Deformities Associated With Neuromuscular Disorders Jong Joo Lee, Sung Han Oh, Yeong Ha Jeong, Sang Man Park, Hyeong Seok Jeon, Hyung-Cheol Kim, Seong Bae An, Dong Ah Shin, Seong Yi, Keung Nyun Kim, Do Heum Yoon, Jun Jae Shin, Yoon Ha Neurospine.2020; 17(3): 513. CrossRef
Differences and characteristics of symptoms by tumor location, size, and degree of spinal cord compression: a retrospective study on 53 surgically treated, symptomatic spinal meningiomas Satoshi Yamaguchi, Arnold H. Menezes, Kiyoharu Shimizu, Royce W. Woodroffe, Logan C. Helland, Patrick W. Hitchon, Matthew A. Howard Journal of Neurosurgery: Spine.2020; 32(6): 931. CrossRef
First
Prev
