STUDY DESIGN:
Case report and review of the literature.

OBJECTIVE:
The aim of this study was to describe a novel approach for anterior cervical fixation, which uses cement augmentation in a patient withosteoporosis.

SUMMARY OF BACKGROUND DATA:
Osteoporotic bone presents a challenge for the treating spine surgeon, and techniques to overcome the difficulty of cervical spine fixation in these patients are lacking.

METHODS:
A 75-year-old woman with osteoporosis presented with cervical myelopathy and was found to have multiple-level cervical stenosis and C3-4 degenerative instability. The patient underwent anterior cervical discectomy fusion and plating from C3-7, with vertebroplastypolymethylmethacrylate augmentation through the screw pilot holes. Because of the patient's grossly soft bone, she also underwent postoperative halo placement.

RESULTS:
No cement extravasation was observed. The halo was removed after 3 months. At 6 months follow-up, the patient had full resolution of her myelopathy. Imaging showed the cervical interbody fusions to be healed at all levels, with no screw pullout or graft subsidence.

CONCLUSIONS:
This represents the first comprehensive description of successful cement augmentation during anterior cervical discectomy fusionand plating in a patient with osteoporosis, accomplishing both an increase in screw pullout strength and a decreased likelihood of graft subsidence. With further study, this technique may represent a viable treatment option in patients with osteoporosis requiring cervical decompression and fusion.