Compression of the Seventh Cervical Vertebra Following C6-7 and C7-T1 Discectomy, PEEK Cage Implantation in these Intervertebral Spaces, and Management of this Complication in a Patient with Multiple Myeloma

摘要

Patients   with multiple myeloma suffer from bone pain, and spontaneous spinal and appendicular bone fractures due to osteoporosis. Osteoporosis occurs as a result of the following 2 factors: 1. Plasma cells secrete macrophage inflammatory protein-1 alpha, which induces osteoclastic activity; 2. Use of corticosteroids.  The incidence of osteoporotic fractures and other complications of multiple myeloma are well described in the literature, but the management of cervical disc herniation and its associated complications has not been reported to date.Herein we present a case that we think exemplifies the management of cervical disc herniation and its complications. Consecutive multilevel cervical discectomy and placement of PEEK cages between the intervertebral cervical disc spaces may cause compression fracture of the vertebrae located between the PEEK cages in osteoporotic patients under continuous corticosteroid treatment¾whether or not they  have MM; therefore, we recommend use of an anterior plate to prevent this complication.