Failure of an expandable cage-plate cervical vertebral body replacement: case report of a device related complication

Instabilities of the cervical spine after complete or incomplete corpectomy may be the result from resection due to stenosis induced myelopathy, tumors, infections or fractures. In this article, we report a 49-year-old female patient after surgical decompression and stabilization at C5/7 with permanent cervicobrachialgia due to cervical stenosis at C5/7. Corpectomy of C6 and stabilization of C5/7 were performed with a combination of cage and plate. At an outpatient control 16 months after reoperation, the patient complained of neck pain, while the control X-ray showed a fracture of the implant. Due to instability of the device, a revision was indicated, resulting in removal of all components with restabilization. Definitive stabilization was performed with a PINA® cage, discectomy and cage implantation at C4/5 and C7/Th1 and a plate from C4 to Th1 with screw fixation in C4/5/Th1. Postoperative course was complication free and the patient was without pain or neurological symptoms at follow-up after 12 months with all implants in radiologically regular position. To the best of our knowledge, this is the first case report to describe such a complication.