PMC9880155_01
Preoperative and postoperative images of anterior cervical discectomy and fusion. (A) A preoperative lateral x-ray image of the patient; (B) A preoperative sagittal CT image of the patient; (C) A preoperative sagittal MR image, revealing spinal stenosis at the C4/5 and C5/6 levels secondary to central disc herniation; (D-F) Postoperative x-ray and CT images, revealing accurate placement of the plates, screws, and cages.
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F1
Imaging results demonstrated spinal stenosis at the C4/5 and C5/6 levels secondary to central disc herniation (Figures 1A-C). ACDF at both levels (C4/5, C5/6) utilizing the right-sided approach (Figures 1D-F). A steel plate was screwed to the C4 and C6 vertebral bodies, with both two screws attached to the C4 and C6 and another screw attached to the C5.
Preoperative images before open-door laminoplasty. (A,B) Preoperative x-ray images showing a large posterior cervical osteophyte at the level of C5/6. (C) A preoperative sagittal CT image showing a large heterotopic bone achieved from the posterior side of the C4 inferior end plate to the posterior side of the C5 superior end plate. (D) A transverse CT image revealing evident cervical stenosis and anterior spinal cord compression due to ossification. (E,F) Preoperative MR images showing the narrow space of the spinal canal and a T2-weighted hyperintense intramedullary signal at the C5/6 level.
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F2
The x-ray images revealed a large posterior cervical osteophyte at the level of C5/6 (Figures 2A,B), which did not exist at the time of the initial procedure. The preoperative sagittal CT images revealed a large heterotopic bone that stretched from the posterior side of the C5 inferior end plate to the posterior side of the C6 superior end plate (Figure 2C). Transversal CT imaging revealed evident cervical stenosis, and ossification compressed the spinal cord anteriorly, resulting in a narrow space laterally for the spinal cord, dura mater, and cerebrospinal fluid (Figure 2D). The preoperative MR images also revealed a narrow spinal canal space and a T2-weighted hyperintense intramedullary signal at the C5/6 level (Figures 2E,F).
One-year follow-up images after open-door laminoplasty. (A,B) Postoperative x-ray images showing the accurate positions into which the plates and screws were installed. (C,D) Postoperative CT images showing direct adherence of all plates to the host bone, creating a new, wide canal space. (E,F) Postoperative MRI images showing decompression of the spinal cord at the C5/6 level.
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F3
The x-ray and CT scans during the one-year follow-up revealed that all the plates had adhered directly to the host bone, widening the canal space (Figures 3A-D). The MRI scan at the one-year follow-up showed decompression at the C4/5 level (Figures 3E,F).