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Preoperative axial T2-weighted MRI showing severe C5-6 cord compression by a massive disc herniation.
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MRI demonstrated a massive herniated nucleus pulposus at C5-6 with severe cord compression and myelomalacia at the level of the herniated disc (Figures 1 and 2).
Preoperative MRI sagittal showing large area of high signal intensity centered behind the massive C5-6 herniated disc.
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MRI demonstrated a massive herniated nucleus pulposus at C5-6 with severe cord compression and myelomalacia at the level of the herniated disc (Figures 1 and 2).
Immediate postoperative MRI after primary C4-5, C5-6 ACDF demonstrates residual C5 compression.
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MRI raised concerns about residual bony compression at C5 (Figure 3). Following intravenous administration of gadopentetate dimeglumine contrast at MRI postoperatively there was no pathologic enhancement of the spinal cord lesion, and therefore the hyperintense changes involving the cervical spine at the C5 level were considered consistent with spinal cord edema (Figure 3).
Day 3 postoperative MRI demonstrates more clearly the spinal cord edema intrinsic to the cord:a "white cord syndrome."
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At day 3 a postoperative MRI demonstrated a large area of high signal changes on T2-weighted MRI intrinsic to the cord ("white cord syndrome") but no residual compression (Figure 4).
Sagittal CT reconstruction at the latest followup shows graft consolidation confirming fusion.
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Radiography and MRI reviewed at this visit confirmed fusion but demonstrated persistent gliosis (Figures 5 and 6).
Sagittal T2-weighted MRI at the latest 16-month followup showing a persistent "white cord syndrome."
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Radiography and MRI reviewed at this visit confirmed fusion but demonstrated persistent gliosis (Figures 5 and 6).