A case of transvertebral anterior cervical foraminotomy for radiculopathy caused by cage subsidence

Background: Cage subsidence is a complication of anterior cervical discectomy and fusion (ACDF). Here, we present a case in which radiculopathy caused by cage subsidence was improved by transvertebral anterior cervical foraminotomy (TVACF). Case Description: A 57-year-old male underwent an ACDF for cervical spondylotic myelopathy at the C5/ C6 level. Postoperatively, although the preoperative abnormal sensations improved, he developed increasing new paresthesia bilaterally in the C6 dermatome distribution. X-rays, 7 months postoperatively, revealed cage subsidence 8 mm into the superior and inferior endplates that resulted in progressive C5/6 intervertebral foraminal stenosis. He underwent a bilateral TVACF with improvement in his bilateral C6 radicular complaints. Conclusion: Bilateral C5/6 TVACF successfully addressed ACDF cage subsidence and resulted in marked improvement in a patient’s new progressive bilateral postoperative C6 radiculopathy.