A critical review on the biomechanical study of cervical interbody fusion cage

Anterior Cervical Discectomy and Fusion (ACDF) is the preferred surgical method for the treatment of severe cervical degenerative disc disease with radiculopathy or myelopathy, of which the objectives are to restore the normal height of intervertebral space and cervical lordosis through the implantation of cervical interbody fusion cage. The biomechanical performance of a cervical interbody fusion cage, which plays a significant role in achieving the goals of ACDF, is influenced by multiple factors. In this paper, various studies focusing on the biomechanical performance of cervical interbody fusion cage are reviewed. Furthermore, the research methods, biomechanical evaluation parameters and data analysis methods of these research are analyzed in order to obtain a comprehensive understanding of the progress and limitations of research in this field. Although great progress has been made to clarify the biomechanical behaviors of cervical interbody fusion cage, there is still controversy regarding the issues such as the relative contribution of multiple factors to the performance of cage, the interactions among these factors, as well as whether the effects of factors change with the process of intervertebral osseointegration and so on. Thus, investigations are still needed to improve the comprehension of cervical interbody fusion cage biomechanically.