PMC9345101_01
Axial and sagittal CT images showing bullet fragments violating the anterolateral vertebral body of L2, with a large bullet fragment lodged in the left L2 pedicle.
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F1
Postoperative computed tomography (CT) imaging showed bullet fragments in and adjacent to the left L2 pedicle, without obvious spinal canal compromise [Figure 1].
Sagittal, coronal, and axial CT myelogram images showing anterolateral cerebrospinal fluid fistula, with leakage of contrast into the left psoas muscle.
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F2
A lumbar CT myelogram was obtained, revealing an area of contrast leakage ventrally into the retroperitoneum in the area of the left L2-L3 neuroforamen without myelographic block [Figure 2].
Anterior-posterior and lateral fluoroscopy images of dorsal epidural blood patch grafting with spinal needle inserted in the thecal sac at L2-3 interspace.
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F3
Given these findings, the patient underwent fluoroscopy-guided dorsal epidural autologous blood patch graft placement at the L2-L3 level [Figure 3].