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erative day 11 and persisted despite temporary pain relief after trigger point injections. Setting: Acute inpatient rehabilitation unit. Results: Cervical spine radiographs demonstrated partial pull out of the C3 anterior fusion plate screws, with anterior displacement of the fibular strut graft with a slight collapse and face joint subluxation. There also was evidence of partial displacement of the C7 screws. She was transferred to orthopedic surgery for revision. Discussion: There is evidence in the medical literature of high failure rates of multilevel cervical corpectomies with instrumentation. However, we believe that this is the first reported case of failure of an ACCD in a patient with comorbidities that would impede bone healing, such as RA and T1DM; this would also be the first reported case of failure after a prior posterior laminectomy. Conclusions: This is a unique case of failure of ACCD and fusion in a patient with RA, T1DM, and a recent history of cervical laminectomy. The patient presented with a nonspecific complaint, such as postoperative cervicalgia, during rehabilitation, which supports the case for more vigilant monitoring with serial radiographs, especially in patients with comorbidities that hinder bone healing. Further studies are required to determine the role of prior posterior laminectomies and fusions, as well as medical comorbidities, in failure rates of ACCD and dynamic plate fixation.