PMC6416757_01
Axial (a), sagittal (b), and coronal (c) noncontrast CT images of thoracic spine preoperatively
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F1
Computed tomography (CT) of the thoracic spine showed acute fracture dislocation at the T11/T12 level, suggesting complete cord transection, and an epidural hematoma from T4-T12 [Figure 1a-c].
(a-i) Sequential intraoperative fluoroscopic images showing spinal realignment and fixation
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F2
T11 corpectomy with adjacent discectomies. To reduce the dislocation, we used a Cobb to elevate T10 superiorly while manually pushing the distal portion of the spine from the patient's back. This was repeated multiple times for stepwise reduction of the bony elements, with deflation and re-inflation of the sandbag to maintain reduction, until adequate alignment was achieved [Figure 2a-i].
Anterior-posterior (a) and lateral (b) radiographs of spinal construct immediately postoperatively
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F3
T10 and T12. The patient was then turned prone again and was internally fixed from T8 to L2 with pedicle screws/rods [Figure 3a and b].
Anterior-posterior (a) and lateral (b) radiographs of spine six months postoperatively showing increased scoliosis
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F4
T12. Three months post-operation, he started to develop a flexible scoliosis of his lumbar spine, which progressed [Figure 4a and b], which was successfully managed with bracing.