PMC4288980_01
A Sagittal T2/STIR-weighted image of the thoracic and lumbar spine obtained seven months preoperatively. Characteristic Morquio A syndrome features are evident, including platyspondyly and relatively large intervertebral disks. Obliteration of the CSF space anterior to the spinal column caused by disk protrusion is evident at T3-4 and T4-5 (white arrows). There was similar protrusion at T2-3 (see Fig. 1B), which is not well seen in this image because mild thoracic dextroconvex scoliosis results in variation of the sagittal plane within the image. Increased cord signal indicative of myelomalacia was not evident. The white dot identifies the body of T3. STIR = short T1 inversion recovery; CSF = cerebrospinal fluid. B Sagittal T2/STIR-weighted image of the thoracic spine obtained 21 hours after emergence from anesthesia. The spinal stenosis observed in Fig. 1A is again evident. The bracket identifies the extent of the abnormal T2/STIR "bright signal" consistent with spinal cord infarction and edema. The white dot identifies the body of T3
nihms636662f1.jpg
PMC4288980_01_nihms636662f1.jpg
F1
T3-4 (with no mention of contour abnormalities of the cord) with milder stenosis at lower levels, slight kyphosis at the thoracolumbar junction, lumbar (L) findings of no obvious central canal stenosis, but minimal cerebrospinal fluid (CSF) around the cord T11-L1. The absence of cord signals suggestive of myelomalacia was noted. The radiologist did not report kyphosis at the C-T junction, but in retrospect, there was exaggeration of the normal thoracic kyphosis at T2-4 (Fig 1A).