PMC7369649_01
The 72-year-old female patient received PSF (Th10 to ilium). (a) Immediate postoperation whole spine posterior-anterior (PA) standing radiograph demonstrates normal coronal alignment. (b) Immediate postoperation whole spine lateral standing radiograph demonstrates normal sagittal alignment. (c) Immediate postrevision lateral view shows normal sagittal alignment. (d) PA view at readmission shows severe PJK (PJA 33.4 deg.). (e) T1-weighed MR image (T1WI) around the UIV area shows bone destruction of both UIV and UIV+1 vertebra. (f) T2WI around the UIV area shows fluid correction around the UIV vertebra. (g) CT scan around the UIV area shows bone destruction of both UIV and UIV+1 vertebra.
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fig1
Schwab-SRS type L ASD (Figures 1(a) and 1(b)). The blood test showed normalization of the white blood cell count (WBC) and C-reactive protein (CRP) at 2 weeks after surgery. She developed proximal junctional kyphosis (PJK) due to Th9 vertebral fracture 2 months after surgery. However, she had acute bilateral leg paralysis and was admitted to our hospital at 12 months after surgery (Figures 1(d)-1(g)). Staphylococcus aureus (MRSA) was detected by both spine and knee cultures, vancomycin and cefazolin were continuously administered for 76 days after admission, when both the WBC and CRP levels returned to normal. She gradually recovered motor function and was discharged 102 days after admission (Figure 1(c)).
PMC7369649_02
The 76-year-old female patient received PSF (Th10 to ilium). (a) Immediate postoperation whole spine PA standing radiograph demonstrates normal coronal alignment. (b) Immediate postoperation whole spine lateral standing radiograph demonstrates normal sagittal alignment. (c) Immediate postrevision whole spine lateral standing radiograph demonstrates normal sagittal alignment. (d) PA view at readmission shows moderate PJK (PJA 18.2 deg.). (e) T1WI around the upper instrumented vertebra (UIV) area shows bone destruction of the UIV vertebra. (f) T2WI around the UIV area shows fluid correction around the UIV+1 vertebra. (g) CT scan around the UIV area shows bone destruction of both UIV and UIV+1 vertebra.
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A 76-year-old female underwent PSF (Th10-ilium) for Schwab-SRS type L ASD (Figures 2(a) and 2(b)), the postoperative course was fine at the beginning, and we had kept follow-up at the outpatient clinic. However, she was readmitted to our hospital due to high fever and bilateral motor weakness 13 months after surgery (Figures 2(d)-2(g)). She gradually recovered motor function (Figure 2(c)).