Peri-Implant Vertebral Body Fracture in a Cervical Integrated Cage Screw Construct: A Case Report of a Rare Complication.

Case: A 33-year-old woman underwent C5-6 anterior cervical discectomy and fusion for progressive cervical myelopathy using an intergrated cage screw construct. Five weeks postoperatively, she presented with neck pain, worsening gait, and weakness after a slight jerk, with imaging showing peri-implant transverse fracture in the C6 vertebral body across the site of Caspar distractor pins and tips of the integrated cage screws. She was treated conservatively with hard collar with close observation, and at 6 months, she was asymptomatic with complete fracture union on imaging.

Conclusion: Peri-implant fracture in a cervical integrated cage screw construct is a rare complication, with biomechanical implications to the pathogenesis, which shows good clinical outcome to conservative treatment.