The patient was operated 1997 for PCD C3-4 at the University hospital, then  by me two times, the first for cervical canal stenosis due to extruded disci C4-5, 4-5 and C5-6 for what discectomy of the above levels was done and fusion of C4-5-6 was done using Zephir cervical plate in 2000. She was also operated for LCS 22-August-2005 with subsequent improvement.

The patient then came 28-January-2012 complaining of left shoulder and neck pain for three months with insomnia due to pain. She was also complaining of difficult swallowing.

On examination, the patient has pain when looking to the left and downward. The power of all limbs is normal and there is hypalgesia of the left foot.

Cervical X-ray done 11-January-2012 showing the loosening of the screws and shifting the upper part of the construct tot eh left side. CT-scan done 21-January-2012 confirming the X-ray data. MRI of the cervical spine done 30-January-2012 showing

The same incision was used and removal of the 2 loose screws and construct was achieved with C-arm control. Diprofos was injected to the supraspinatus area left shoulder.

Routine closure of the wounds. Smooth postoperative recovery with disappearance of the left shoulder pain.

The Zephir cervical plate was abandoned in our activity for more than 10 years after 10 cases of their use. The construct have several disadvantages which are resolved in other brands.

Here, even after 12 years the screws slipped out and the construct upper portion migrated to the left causing pain in the left shoulder and difficult swallowing.