I have two (technically 3 helices) on my layout (two helix structures, but one has two separate routes on the same roadbed). All are hidden. I used the same roadbed and spacer method as shown above, except for the spacers and screw heads sitting under the blocks in the picture above. I also use 1/2 plywood for the roadbed and cut all my spacer blocks to the width I needed to get the grade I wanted. I also had a bit of weirdness in that on the double helix I had to get the inside track to the outside, so I ran it around on one additional loop.
Here is the base for the helix. I use a base so I have a level place to start building from.
I then cut a series of stepped blocks to establish the grade. They are glued to the base.
Each turn is applied by screwing the roadbed arcs to the blocks, track is laid as I go. I use 1/2" #6 pan head screws on the track centerline to screw the track to the roadbed. If I later need to adjust or remove track I can unscrew or loosen the screws and then tighten them back up again. Once the track is in place I glue spacer blocks to the outside of the roadbed. Then the next layer of roadbed is applied and screwed to the spacer blocks. I make the roadbed joints fall on the spacer blocks so they become the splice blocks for each turn.
Finally I use risers to lift the base and the whole helix up to the final height. You might also notice I added that "extra" turn to the outside of the helix getting the inside turn to the outside.
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A helix has four design components, the radius, the spacing between turns, the grade and the total rise. It has to be designed to take all three of those into account. The first two determine the grade. Personally I wouldn't go below 24" radius in HO.
Then its a matter of how much space you need between levels and the resulting grade. On my layout, since I'm modeling 1900-1905, and using small steam engines, I had to keep the grade low, therefore I went to 27" radius and only three inches between levels (2 3/8" of clear space) because I'm not running double stacks or auto racks. If you are running modern equipment, with 19" radius and 4" between levels, that's 3.3% grade. The length of one turn = 2 x radius x 3.14, then divide the separation between levels by the length of a turn and multiply by 100 to get the grade. 19" x 2 = 38" x 3.14 = 119, 4/119 = 0.033 x 100 = 3.3
You also have to take into account there will be a vertical curve at the top and bottom of the grade to get the slope to flat.
A helix doesn't have to be completely hidden. You can bulge a turn or two out from the helix structure to create a visible scene in the middle of the helix. I also visited a club that had a large diameter helix (36" radius?) at the end of a peninsula. It was designed so the turns were little shelves with a back drop behind them and totally visible for about 3/4 of the turn. The tracks were ballasted and the backdrop painted with sky and tree line. You could easily watch your train run up or down the helix.