Salzmann SN, Okano I, Ortiz Miller C, et al. - This study was undertaken to ascertain possible trabecular BMD variations throughout the cervical spine and first thoracic vertebra in patients undergoing anterior cervical discectomy and fusion (ACDF) and to estimate the association between BMDs of the spinal levels C1-T1. Researchers conducted a retrospective case series including individuals who underwent ACDF between 2015 and 2018 at a single, academic institution with available preoperative CT imaging. A total of 194 patients (men, 62.9%) were enrolled in this study. This is the largest research evaluating trabecular BMD of the entire cervical spine and first thoracic vertebra by QCT. The patient sample consisted of individuals experiencing ACDF, which adds to the clinical relevance of the findings. It was indicated that understanding BMD variation in the cervical spine might be beneficial to surgeons utilizing anterior cervical spine plate and screw systems. The methods involving instrumentation at lower density caudal levels might potentially help from a modification in instrumentation or surgical technique to achieve outcomes similar to more cephalad levels due to the significant variation in cervical BMD.