Fig. 2.

A 47-year old female suffered a motor vehicle accident 1 year prior to presentation with C6–7 jumped facets and complete motor and sensory loss corresponding to the C7 level at that time. She underwent reduction and in situ fusion with anterior cervical discectomy and fusion and posterior intraspinous wiring at that time (a–c). She now presented with increasing neck pain and rapidly deteriorating triceps function. She underwent a 540° fusion with removal of posterior instrumentation, osteotomy of posterior fusion mass, complete facetectomy, and placement of lateral mass screws from C3 to C6 and pedicle screws from C7 to T3, followed by removal of anterior instrumentation, C7 complete corpectomy, reduction of deformity, anterior cage and plating from C6 to T1, followed by posterior compression and rod insertion (d–f)