PMC9256016_01
Sagittal (A) and transaxial (B, C) T2-weighted MRI showed the development of cervical spinal canal stenosis at C3/4 (B) and C4/5 (C).
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Cervical magnetic resonance imaging (MRI) revealed spinal canal stenosis at the C3/4 and C4/5 levels (Fig. 1A-C).
CT scans of the sagittal (A), coronal (B) and axial views on the day after the operation revealed swelling of the front of the vertebral body from the post-pharyngeal wall.
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CT-scan on the day after the operation revealed swelling of the front of the vertebral body from the post-pharyngeal wall (Fig. 2).
The diameter of the retropharyngeal space ( ) at the C2 vertebral body in the lateral view of cervical spine X-rays was 3.3 mm on admission (A), 15.8 mm a day after the operation (B), 10.7 mm 7 days after the operation, and 4.5 mm at discharge (12 days after the operation).
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The diameter of his retropharyngeal space in the lateral view of the cervical spine X-rays showed a marked enlargement to 15.8 mm it was 3.3 mm preoperatively (Fig. 3A, B).) Although the postoperative JOA score showed a slight improvement to 10 points, pain in both shoulders, numbness and skillful movement disorders in both hands remained. The retropharyngeal space in the cervical X-rays was 10.7 mm 7 days after the operation (Fig. 3C). The patient could use chopstick, and the retropharyngeal space in the cervical X-rays was reduced to 10.7 mm seven days after the operation (Fig. 3C). When he was discharged from the hospital, the only neurological symptom was mild numbness in both hands, the JOA score was 16 points, and the retropharyngeal space in the cervical X-rays was reduced to 4.5 mm (Fig. 3D).
Laryngoscope finding disclosed the retropharyngeal strong edema in the front of the vertebral body (arrow).
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Based on an otolaryngology examination, his inability to swallow after the operation appered due to esophageal trismus because of strong edema in the front of the vertebral body as shown by laryngoscope (Fig. 4).