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The previously demonstrated C4-6 ACDF has separated anteriorly from the vertebral bodies, measuring up to 6.2 mm from the vertebral body of C4 and 4.6 mm from the vertebral body of C5 (previous flush alignment). As a result, the C4 and C5 verterbral body screws are now angulated inferiorly. The interbody fusion devices remain in situ. Slight loss in the vertebral body height of C4, C5 and C6, with endplate fractures and impaction of the intervertebral spacing devices into the vertebral bodies. There is loss of the normal cervical lordosis. The remainder of the study is unchanged.
Conclusion: The C4-6 ACDF has loosened, with separation of the plate from the anterior vertebral bodies. There is loss of intervertebral height at C4/5 and C5/6, with impaction of the intervertebral spacing devices into the endplates. Straightening of the spine, with loss of normal lordosis.