PMC9276974_01
MRI findings after the initial fall; radiographs after the PKP surgery. (A,B) T1-weighted images revealed compression fractures of the L1 and L2 vertebrae (yellow arrow). (C,D) The radiograph image reveals L1 and L2 vertebrae that were treated with percutaneous kyphoplasty (yellow circle).
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F1
He was admitted to the local hospital, where he was diagnosed with vertebral compression fractures of L1 and L2 and osteoporosis (Figures 1A,B). He then underwent percutaneous kyphoplasty, after which the pain was mildly relieved (Figures 1C,D).
Images were taken at the initial visit to our hospital. (A,B) A full-length radiograph of the patient's spine indicated sagittal imbalance of the spine (Cobb's angle: 45 , PI: 37 , PT: 26 , SS: 11 ). (C-F) MRI indicated post-vertebroplasty of L1 and L2 and T12-L2 vertebral body with bone edema (yellow arrow).
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F2
A full-length spine radiograph showed post-vertebroplasty of L1 and L2, compression fracture of T12, kyphosis with sagittal imbalance (Cobb's angle: 45 , PI: 37 , PT: 26 , SS: 11 ), and severe osteoporosis (Figures 2A,B). MRI of the lumbar spine showed T12-L2 bone edema (Figures 2C,F).
Imaging features after initial surgery at our hospital. (A,B) Postoperative 1-week radiograph indicated alleviation of the kyphosis. (C-G) Postoperative 1-week CT scan indicated good internal screw fixation (Cobb's angle: 10 ).
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F3
Postoperative lumbar spine radiography and CT showed that the kyphosis was corrected and the nail rod was not loosened (Figures 3A-F).
Postoperative 1-month and 3-month imaging findings at our hospital. (A,B) Postoperative 1-month radiograph indicated loosening of the internal fixation screw of the L3 vertebral body (yellow arrow). (C,D) Postoperative 3-month follow-up full-length radiograph of the patient's spine indicated Cobb's angle increased to 26 , failure of internal fixation. (E,F) Postoperative 3-month follow-up CT scan indicated that the L3 vertebral body was loosely fixed internally and the screws had resorbed the surrounding bone (yellow arrow).
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F4
Unfortunately, a follow-up radiograph (Figures 4A,B) taken 1 month after surgery showed a loosening of the L3 pedicle screw. CT scan and radiograph of the spine showed that the L3 vertebral body was loosely fixed internally and the screws had resorbed the surrounding bone (Figures 4C-F).
Imaging findings 3 days after revision surgery at our hospital. (A,B) 3 days after revision surgery full-length radiograph of the patient's spine indicated that Cobb's angle decreased to 20 . (C-E) CT scan indicated good internal screw fixation.
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F5
Imaging 3 days after revision surgery showed that kyphosis was corrected (Cobb's angle: 22 , PI: 44 , PT: 23 , SS: 21 ) and the nail rod was not loosened (Figures 5A-E).
Imaging findings after revision surgery at our hospital. (A,B) One-month follow-up postoperative radiograph indicated good spinal stability without loosening of the screws. (C,D) Three-month follow-up postoperative radiograph indicated good spinal stability without loosening of the screws. (E,F) The patient's radiograph was reviewed 6 months after surgery and showed the good orthopedic status of the spine without loosening of the internal fixation screws. (G,H) Follow-up radiographs taken 1.5 years after surgery showed no loosening of the internal fixation and good spinal orthopedic status.
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F6
One month after revision surgery, imaging showed that the kyphosis was corrected and the internal fixation was stable (Figures 6A,B). At 3-month and 6-month follow-ups, the patient was in good condition and the internal fixation was stable (Figures 6C-F). At the last follow-up conducted 1.5 years after the revision surgery (Figures 6G-H), the patient was in good condition and did not complain of lower back discomfort.