PMC7710696_01
Conventional X-rays of the whole spine in two planes in standing position (ap-view left and lateral view right) revealing the ossification and the kyphotic deformity of the whole spine with sagittal imbalance as well as the reduced bone mineral density.
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F1
The whole spine conventional X-rays in two planes revealed an ossification of the spine, reduced bone mineral density, a global kyphotic deformity with a sagittal imbalance and the kyphotic healed fracture at the level L1 (Figure 1 (Fig. 1)).
The CT scan with sagittal reconstruction shows the ossification and the global kyphosis of the whole spine and the old fracture at the level L1 healed in a kyphotic position.
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F2
The CT scan showed the typical complete ossification of the spine and the described kyphotic deformity (Figure 2 (Fig. 2)).
The intraoperatively taken fluoroscopy shows a fracture of the ankylosed disc L2/3 with a wedge-shaped gape without any translation or rotation (left). The fluoroscopic control performed a short time before to assess the right screw position shows the later fractured level without any particularity (right).
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F3
The immediately performed fluoroscopy showed a spontaneous fracture at the level of the ankylosed disc L2/3 (Figure 3 (Fig. 3)).
The conventional X-rays of the lumbar spine after the first operation in two planes (ap view left, lateral view right) show the improved position of the spine, however, compared to the intraoperative fluoroscopy (Figure 3), a partial loss of correction.
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F4
Furthermore, bone was replaced posteriorly to support fusion and surgery could be completed (Figure 4 (Fig. 4)).
The whole spine conventional X-rays after the second surgery reveal an improved sagittal profile, however, the initially planned and desired amount of correction has not been reached completely.
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F5
This second surgery could be performed without any problem (Figure 5 (Fig. 5)).