The purpose of this study was to evaluate and compare by finite element analysis the biomechanical performance, in terms of cervical stand-alone cage screw insert angle (Type 3 – 5: 2 Screws) and screw arrangement (Type 6 and 7: 3 Screws / Type 8 and 9: 4 Screws), and the range of motion (ROM) of traditional anterior cervical discectomy of a fusion device (Type 1: Cage / Type 2: Cage + ACP). Our study suggests that the biomechanical behavior of a postoperative cervical spine could indeed be influenced by design features, such as screw angle and number of screws. In particular, ROM and the risk of subsidence were more sensitive during extension about type 5 (Insert Angle 20°). Our study also suggested that the number of screw asymmetries between up and down for type 6 and 7 could result in differences in the risk of screw fracture manifesting in different clinical aspects.
