was sufficient to result in symptoms. Nonetheless, a high

index of suspicion should be present postoperatively for the

development of spondylolisthesis in patients undergoing an

anterior cervical corpectomy and fusion procedure, partic-

ularly in individuals with persistent or new symptoms even

after a bsuccessfulQ operative procedure.

References

[1] DiAngelo DJ, Foley KT, Vossel KA, et al. Anterior cervical plating

reverses load transfer through multilevel strut-grafts. Spine 2000;25:

783 -95.

[2] Epstein NE. Anterior cervical dynamic ABC plating with single level

corpectomy and fusion in forty-two patients. Spinal Cord 2003;41:

153 -8.

[3] Epstein NE. The value of anterior cervical plating in preventing

vertebral fracture and graft extrusion after multilevel anterior cervical

corpectomy with posterior wiring and fusion: indications, results, and

complications. J Spinal Disord 2000;13:9 -15.

[4] Foley KT, DiAngelo DJ, Rampersaud YR, et al. The in vitro effects of

instrumentation on multilevel cervical strut-graft mechanics. Spine

1999;24:2366-76.

[5] Perez-Cruet MJ, Samartzis D, Fessler RG. Anterior cervical dis-

cectomy and corpectomy. Neurosurgery 2006;58:ONS-355 [discus-

sion ONS-59].

[6] Rockwell R, Shen FH, Allaire P, et al. The biomechanical behavior of

a rigidly instrumented three-level corpectomy construct under

physiologic loads: a novel finite element model. Spine J 2005;5:

153 -4.

[7] Sasso RC, Ruggiero Jr RA, Reilly TM, et al. Early reconstruction

failures after multilevel cervical corpectomy. Spine 2003;28:140 -2.

[8] Vaccaro AR, Falatyn SP, Scuderi GJ, et al. Early failure of long segment

anterior cervical plate fixation. J Spinal Disord 1998;11:410-5.

[9] Wang JC, Hart RA, Emery SE, et al. Graft migration or displacement

after multilevel cervical corpectomy and strut grafting. Spine 2003;28:

1016-21 [discussion 21-2].

[10] Zdeblick TA, Bohlman HH. Cervical kyphosis and myelopathy.

Treatment by anterior corpectomy and strut-grafting. J Bone Joint

Surg Am 1989;71:170 -82.

Commentary

Not all surgeons are willing to share their complications.

The authors are to be praised for doing so and explaining

why an apparent bperfectQ postoperative radiographic result

was not so. They listened to the patient, examined her, and

sought an explanation.

Howard Morgan, MD

Department of Neurosurgery

UT Southwestern Medical Center

Dallas, TX 75390, USA

Fig. 5. A: Postoperative lateral plain radiograph of the cervical spine after

laminectomy of C5-C7 demonstrating strut graft fusion and proper

placement with no associated complications of the anterior and posterior

instrumentation of C5-C7. B: Postoperative T2-weighted sagittal MRI

illustrating cervical spinal cord decompression after laminectomy of C5-C7.

F.H. Shen, D. Samartzis / Surgical Neurology 69 (2008) 637–640640