• Rui Feng, Joshua Loewenstern, and John Caridi.
• Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
• World Neurosurg. 2017 Sep 1; 105: 1041.e1-1041.e5.

BackgroundCervical stand-alone interbody cages have seen increasingly wider use over the plate-and-screw construct in single-level anterior cervical discectomy and fusion (ACDF) in the treatment of cervical disc herniation and degenerative spondylotic conditions. Despite positive clinical outcomes, the efficacy and safety of using these devices in contiguous multilevel ACDF has remained controversial. This report discusses a burst fracture seen as a complication in multilevel cervical stand-alone cage use.Case DescriptionA 39-year-old woman with a history of C5-C6 and C6-C7 ACDF with contiguous stand-alone interbody cages 2 years prior, presented with recurrent arm and neck pain with myelopathy. Computed tomography scan revealed a burst fracture of the C6 vertebral body with retropulsion of fragments compressing the spinal cord.ConclusionsThis case suggests that use of cervical stand-alone cages in contiguous levels may cause late complications despite good instrumentation and illustrates the need for more careful consideration of technique selection in multilevel ACDF.Copyright © 2017 Elsevier Inc. All rights reserved.

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