PMC4968989_01
(A and B) Standing radiographs (anteroposterior and lateral view) showing degenerative disc change with retrolisthesis of L2-L3 and L3-L4; (C) the first immediately postoperative radiograph after instrumented fusion from L1 to L5 with cement augmentation of T12 and L1.
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Postoperatively, her lower back pain and neurologic condition improved with good sagittal balance (Figure 1).
Seven weeks after the first surgery.. Notes: (A) Lateral view radiograph demonstrating subluxation of T12 with proximal junctional angle of 52  (T11-L1). (B) Computed tomography scan of spine showing T12 subluxation. (C) The second immediately postoperative radiograph 15 weeks after the previous surgery with spinal instrumentation from T9 to L5 with cement augmentation of T8 and T9.
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The radiographs showed restored alignment of the spine (Figure 2).
(A) Lateral radiograph demonstrating vertebral subluxation of T8 with proximal junctional angle of 36  (T7-T9) 19 days after previous surgery; (B) magnetic resonance image showing T8 subluxation with severe cord compression; (C) the third immediately postoperative radiograph.. Note: The patient underwent extensive instrumented fusion from T2 to L5.
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T8-T9 level. The following surgery was performed on September 19, 2013, that is, extension of the spinal rods reached T2, which was augmented with cement. T1 did not have prophylactic vertebroplasty (Figure 3), and her neurologic grade and low micturition function were improving slowly.
(A and B) The final whole spine radiographs; (C) magnetic resonance image showing fracture subluxation of T1 with proximal junctional angle of 28  (C7-T2) and severe cord compression 5 weeks after previous surgery.
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The magnetic resonance image demonstrated T1 compression fracture involving the inferior end plate and 28  segmental kyphosis with spinal cord compression (Figure 4).