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


  • Salih Gulsen Baskent University Medical Faculty Hospital - Neurosurgery, Maresal Fevzi Cakmak cad.10. sok. No: 45, Ankara 06540



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.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


Wright JH. A case of multiple myeloma. J Boston Soc Med Sci. 1900;4:195-204-5.

Kyle RA, Rajkumar SV. Criteria for diagnosis, staging, risk stratification and response assessment of multiple myeloma. Leukemia. 2009;23:3-9.

Wirk B. Renal failure in multiple myeloma: a medical emergency. Bone Marrow Transplant. 2011;46:771-83

Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;61:69-90.

Landgren O, Weiss BM. Patterns of monoclonal gammopathy of undetermined significance and multiple myeloma in various ethnic/racial groups: Support for genetic factors in pathogenesis. Leukemia. 2009;23:1691–1697.

Kyle RA, Gertz MA, Witzig TE, et al. Review of 1,027 patients with newly diagnosed multiple myeloma. Mayo Clinic Proc. 2003;78:21–33.

Durie BG, Salmon SE. A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival. Cancer. 1975;36:842-54.

Brooke NS, Rorke AW, King AT et al. Preliminary experience of carbon fiber cage prostheses for treatment of cervical spine disorders. Br J Neurosurg. 1997;11:221–227

Munoz FL, de las Heras BG, Lopez VC et al. Comparison of three techniques of anterior fusion in single-level cervical disc herniation. Eur Spine J. 1998;7:512–516

Song KJ, Lee KB. A preliminary study of the use of cage and plating for single-segment fusion in degenerative cervical spine disease. J Clin Neurosci. 2006; 13(2):181–187

Cho DY, Liau WR, Lee WY, Liu JT, Chiu CL, Sheu PC. Preliminary experience using a polyetheretherketone (PEEK) cage in the treatment of cervical disc disease. Neurosurgery. 2003; 51(6):1343–1349.

Song KJ, Taghavi CE, Hsu MS, Lee KB, Kim GH, Song JH (2010) Plate augmentation in anterior cervical discectomy and fusion with cage for degenerative cervical spinal disorders. Eur Spine J. 2010; 19:1677–1683.

Barsa P, Suchomel P. Factors affecting sagittal malalignment due to cage subsidence in standalone cage assisted anterior cervical fusion. Eur Spine J. 2007;16(9):1395–1400.

Schmieder K, Wolzik-Grossmann M, Pechlivanis I, Engelhardt M, Scholz M, Harders A. Subsidence of the wing titanium cage after anterior cervical interbody fusion: 2-year follow-up study. J Neurosurg Spine. 2006;4(6):447–453.

Kulkarni AG, Hee HT, Wong HK. Solis cage (PEEK) for anterior cervical fusion: preliminary radiological results with emphasis on fusion and subsidence. Spine J. 2007; 7(2):205–209.

Papadopoulos EC, Huang RC, Girardi FP, Synnott K, Cammisa FP. Three-level anterior cervical discectomy and fusion with plate fixation: radiographic and clinical results. Spine. 2006; 8:897–902.

Melton LJ, 3rd, Rajkumar SV, Khosla S, et al. Fracture risk in monoclonal gammopathy of undetermined signiï¬cance. J Bone Miner Res. 2004;19:25–30.

Nasto LA, Fusco A, Colangelo D, Mormando M, Di Giacomo G, Rossi B, De Marinis L, Logroscino CA, Pola E. Clinical predictors of vertebral osteoporotic fractures in post-menopausal women: a cross-sectional analysis. Eur Rev Med Pharmacol Sci. 2012;16(9):1227-34.




How to Cite

Gulsen S. 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. Open Access Maced J Med Sci [Internet]. 2014 Sep. 15 [cited 2022 Aug. 15];2(3):467-71. Available from:



C- Case Reports

Most read articles by the same author(s)