PMC10401035_01
Preoperative x-ray (A) and reconstruction 3D CT (B) depicted complete posterior spondylopotosis of the upper 1/3 T12 overriding to the lower part of T12. Sagittal T2-weighted MRI (C) depicted a completely distorted thecal sac and spinal cord.
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F1
An emergency radiological examination revealed an overriding of upper T12 fragments posterior to the lower part of T12 with apparent spinal shortening and complete disruption of the thecal sac as evidenced on X-ray (Figure 1A), CT scanning and reconstruction (Figure 1B), and MRI imaging (Figure 1C).
Illustration of partial vertebrectomy marking the resection. Eight pedicle screws with long tails were inserted into T10-L2. A temporary rod was inserted transversely between the pedicle screws at the level above and below the dislocation. The upper vertebral body of posteriorly dislocated T12 and its overlying disc were removed completely using rongeurs and forceps in a piecemeal fashion to facilitate distraction (as indicated by the red curve). The rods with appropriate anatomic sagittal profile were introduced first to the superior pedicle screws and the caudal part of the spine was reduced by means of submitting the 2 rods into the inferior screw heads which were purposely pre-contoured. The remaining lower approximate 2/3 part of the T12 body and the inferior endplate of T11 was curetted until the cancellous bone was well exposed for arthrodesis.
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F2
T12 and its overlying disc were removed completely using rongeurs and forceps in a piecemeal fashion to facilitate distraction, namely, a partial vertebrectomy as illustrated in Figure 2, marking the resected parts. The remaining lower approximately two-thirds of the T12 body and the inferior endplate of T11 were curetted until cancellous bone was well exposed for arthrodesis.
Immediate x-rays (A) after surgery showed satisfactory reduction of T12 dislocation by partial T12 vertebrectomy and spine shortening, with T10-L2 instrumentation and T11-12 spinal interbody fusion; At 24 months follow-up, x-rays (B) and CT scans (C) demonstrated that the good reduction was maintained and excellent interbody fusion at the osteotomy site was achieved.
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F3
The postoperative X-rays depicted a satisfactory reduction with good contact between T11 and the remaining T12 (Figure 3A). The good reduction was sustained (Figure 3B) and solid interbody fusion was confirmed on reconstructive CT (Figure 3C).